Drinking alcohol may reduce the pain, stiffness, and joint damage caused by rheumatoid arthritis, reports new research. The study also found that people who drink alcohol are less likely to develop this joint disease in the first place, confirming the results of previous research.

What do we know already?

If you have rheumatoid arthritis (RA), your joints become stiff, painful, and swollen. This occurs because your immune system mistakenly starts attacking the linings of your joints, making them inflamed.

Researchers don't fully understand the complex process that leads to RA. Your genes can play a role, as can factors in your environment and lifestyle. For example, studies show that smoking increases the risk of RA, and regularly drinking alcohol may lower it. Research in mice also suggests that drinking alcohol may help lessen the severity of the illness.

To learn more about alcohol's possible effects, researchers have now done a study comparing 873 people with RA and 1,004 people without the disease. They asked participants about whether they drank alcohol, and on how many days in the last month they'd had at least one drink. Among those with RA, the researchers also used questionnaires, blood tests, and x-rays to assess the severity of their disease.

What does the new study say?

Overall, people who drank no alcohol were more than twice as likely as alcohol drinkers to have rheumatoid arthritis. And, compared with people who drank frequently (on more than 10 days a month), non-drinkers had four times the risk.

Among those with RA, overall, joint problems were less severe in people who drank more frequently. For example, their blood tests indicated less inflammation, their x-rays showed less joint damage, and their questionnaires revealed less pain, stiffness, and movement problems.

The researchers found similar results after taking into account other factors that might have affected the severity of people's disease, including their age, sex, and what medicines they were taking for RA. The researchers paid particular attention to whether people were taking a commonly prescribed drug called methotrexate. This is important, as people prescribed methotrexate are often advised to limit their alcohol intake to avoid possible liver problems.

How reliable are the findings?

This study found a close link between how frequently people drank alcohol and their RA risk and severity. This closeness makes it less likely that these findings are down to chance. It's also worth noting that the study confirmed other research showing that drinking alcohol may decrease the risk of RA.

But this type of study can't show cause and effect, so we can't be certain that drinking alcohol was what lowered people's risk of RA or the severity of their illness. RA is a complex disease and there could have been something else about people who drank alcohol that lowered their risk. The study also had a few other limitations:

• The researchers relied on participants to remember how often they'd consumed alcohol over the past month. This isn't a very reliable approach, as people's memories can be faulty.
• The study didn't explore what types of alcohol people drank or how much. These factors could be important. Some people say that certain drinks, such as red wine, make their arthritis worse.
• All the people in the study were white. So we can't be certain that these findings apply to other ethnic groups.

Where does the study come from?

The study was conducted by researchers with the University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust. It was funded by a grant from the Arthritis Research Campaign and appeared in a journal called Rheumatology, which is owned by the British Society for Rheumatology.

What does this mean for me?

This is the first study in humans to explore whether drinking alcohol might lessen the severity of RA, and its results are promising. However, it's too soon to recommend alcohol as a treatment if you have RA, as there are many questions yet to be answered, including what types of alcohol might be most beneficial and how much people should drink.

However, we do know that drinking a lot of alcohol can be harmful in other ways, potentially leading to liver damage and high blood pressure, among other problems. You should be particularly cautious about drinking alcohol if you take methotrexate.

What should I do now?

There's nothing you need to do based on this research. But if you have RA and drink alcohol, you may have reason to enjoy your drinks a bit more.

From:

Maxwell JR, Gowers IR, Moore DJ, et al. Alcohol consumption is inversely associated with risk and severity of rheumatoid arthritis. Rheumatology. 2010. Published online under advance access. doi:10.1093/rheumatology/keq202.

To learn more, see our information on rheumatoid arthritis.

© BMJ Publishing Group Limited ("BMJ Group") 2010