HLA-DRB1 and rheumatoid arthritis: Alcohol consumption is also associated with lower disease activity and self-reported health assessment in RA.112 A three-way interaction between alcohol, smoking, and HLA-DRB1-SE has been reported regarding the risk for ACPA-positive RA.113 These findings emphasize the need to investigate interactions between several environmental and genetic factors in order to understand the disease occurrence better.