logo
In press
In Press
Recent issue
Recent issue
archives
Archives
Search
Search
 

Review

 

Is the controversial role of alcohol in arthritis still a Hamletic dilemma?

1, 2, 3, 4, 5, 6

 

  1. Rheumatology SOC, Multidimensional Department, Santa Maria Nuova and Santissima Annunziata Hospital, USL Tuscany Center, Florence, Italy. francesca.bandi@gmail.com
  2. Rheumatology SOC, Multidimensional Department, Santa Maria Nuova and Santissima Annunziata Hospital, USL Tuscany Center, Florence, Italy.
  3. Department of Agriculture, Food, Environment and Forestry, University of Florence, Italy.
  4. Tos.Co.Vit, Tuscany Wine Maker’s Association, San Piero a Grado, Pisa, Italy.
  5. Rheumatology SOC, Multidimensional Department, Santa Maria Nuova and Santissima Annunziata Hospital, USL Tuscany Center, Florence, Italy.
  6. Institute of Research on Terrestrial Ecosystems (IRET), National Research Council (CNR), Sesto Fiorentino, Florence, Italy.

CER27
2026 Vol.3, N°1
PI 0015, PF 0024
Review

Received: 10/04/2026
Accepted : 25/05/2026
In Press: 28/05/2026
Published: 28/05/2026

Abstract

While alcohol consumption is widely considered detrimental in rheumatic diseases, literature suggests its effects might vary depending on dose, beverage type and specific disease context. This narrative review examines current evidence studying the relationship between alcohol intake and disease activity in inflammatory arthropathies, such as rheumatoid arthritis (RA), gout and spondyloarthritis (SpA). Specifically, we aim to evaluate the potential beneficial or harmful effects of alcohol on different inflammatory joint diseases, accounting for variations in beverage type and consumption volume. As a secondary objective, we investigate the impact of alcohol on intestinal homeostasis within these rheumatic conditions. Observational studies in RA suggest that low-to-moderate alcohol consumption may be associated with a reduced risk of disease onset and lower disease activity; however, causality remains uncertain due to confounding factors. Conversely, alcohol intake in gout and SpA consistently shows dosedependent detrimental effects that accelerate disease progression. Nevertheless, pivotal studies indicate that certain non-ethanol compounds found in red wine, such as polyphenols and resveratrol (RS), can reduce inflammation. While chronic alcohol consumption disrupts intestinal homeostasis by promoting gut dysbiosis and compromising barrier integrity, potentially fuelling systemic inflammation, RS may exert microbiota-modulating and anti-inflammatory effects in experimental models. Overall, current evidence does not support alcohol consumption as a therapeutic strategy in rheumatic diseases. Its effects must be interpreted with caution, balancing disease-specific risks against dose-dependent biological responses.

DOI: https://doi.org/10.55563/jer/1c424f

Rheumatology Article