WebMD Medical News
Laura J. Martin, MD
July 28, 2010 -- Rheumatoid arthritis patients who drink alcohol tend to have less severe symptoms than those who don’t, a new study finds.
Earlier research has shown that compared to teetotalers, alcohol drinkers are less likely to develop rheumatoid arthritis, a progressive and often disabling inflammatory disease that attacks the joints.
But the study is the first to suggest drinking alcohol can lessen the severity of symptoms in people who already have the disease.
Patients in the study who drank at least 10 alcoholic beverages a month had 20% to 30% less pain and inflammation than patients who didn’t drink alcohol, rheumatologist and study co-author James Maxwell of England's University of Sheffield tells WebMD.
While he acknowledges more study is needed to confirm the association, Maxwell says the evidence is mounting that moderate alcohol consumption reduces both the risk and severity of rheumatoid arthritis.
“Generally speaking, it appears that drinking alcohol in moderation may benefit patients with rheumatoid arthritis.”
But an arthritis specialist who spoke to WebMD remains unconvinced, calling the study "very weak science.”
Rheumatologist Nortin M. Hadler, MD, who is a professor of medicine at the University of North Carolina School of Medicine, says many previous studies have linked moderate alcohol consumption with longer life and better health.
“But before anyone leaps to the bottle, realize that in many resource-advantaged countries this ‘moderate’ level of imbibition is associated with higher socioeconomic status, which itself bodes well for mortality and for rheumatoid arthritis prognosis,” he writes in an email.
Many patients with rheumatoid arthritis, especially those who take the drug methotrexate, are advised not to drink alcohol because methotrexate and alcohol can be toxic to the liver.
Hadler says he discusses these risks with his patients and urges them to limit their alcohol consumption if they choose to drink.
In the study, which was published online in the journal Rheumatology, 873 people with rheumatoid arthritis and 1,004 people without the disease were asked to recall their alcohol consumption during the previous month.
Participants were also given X-rays and blood tests to measure inflammation and other markers of joint damage and disease progression.
The researchers found that non-drinkers were roughly four times as likely to develop rheumatoid arthritis as people who drank alcohol more than 10 days a month. This was true for both men and women.
Patients who drank alcohol more than 10 times a month also had fewer and less severe symptoms than non-drinkers or people who drank less frequently. They also showed less damage to joints on X-rays, and blood tests showed lower levels of inflammation.
One limitation of the study, however, was that the researchers did not know how much alcohol people actually drank when they imbibed. In addition, the patients in the study tended to be older than the non-patients, which could affect the results.
Maxwell says alcohol may lessen the severity of arthritis symptoms by reducing inflammation or by acting as an analgesic.
He says a study that more directly measures alcohol consumption and follows patients over time could help clarify the role of alcohol, if any, in reducing pain and other symptoms of rheumatoid arthritis.
“This finding hasn’t been shown before, but I would urge caution,” he says. “More study is definitely needed.”
SOURCES:Maxwell, J.R. Rheumatology, July 28, 2010; online edition.James R. Maxwell, MD, senior lecturer, University of Sheffield; department of rheumatology, Rotherham Hospital, Rotherham, England.Nortin M. Hadler, MD, MACP, professor of medicine and microbiology, University of North Carolina School of Medicine, Chapel Hill, NC; spokesman, American College of Rheumatology.News release, Oxford University Press.
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