Smoking and response to rituximab in rheumatoid arthritis : results from an international European collaboration

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http://hdl.handle.net/10138/297078

Lähdeviite

Chatzidionysiou , K , Lukina , G , Gabay , C , Hetland , M L , Hauge , E M , Pavelka , K , Nordström , D , Canhao , H , Tomsic , M , Rotar , Z , Lie , E , Kvien , T K , van Vollenhoven , R F & Saevarsdottir , S 2019 , ' Smoking and response to rituximab in rheumatoid arthritis : results from an international European collaboration ' , Scandinavian Journal of Rheumatology , vol. 48 , no. 1 , pp. 17-23 . https://doi.org/10.1080/03009742.2018.1466363

Julkaisun nimi: Smoking and response to rituximab in rheumatoid arthritis : results from an international European collaboration
Tekijä: Chatzidionysiou, K.; Lukina, G.; Gabay, C.; Hetland, M. L.; Hauge, E. M.; Pavelka, K.; Nordström, D.; Canhao, H.; Tomsic, M.; Rotar, Z.; Lie, E.; Kvien, T. K.; van Vollenhoven, R. F.; Saevarsdottir, S.
Muu tekijä: University of Helsinki, University Management



Päiväys: 2019-01-02
Kieli: eng
Sivumäärä: 7
Kuuluu julkaisusarjaan: Scandinavian Journal of Rheumatology
ISSN: 0300-9742
DOI-tunniste: https://doi.org/10.1080/03009742.2018.1466363
URI: http://hdl.handle.net/10138/297078
Tiivistelmä: Objectives: To investigate whether smoking habits predict response to rituximab (RTX) in rheumatoid arthritis (RA). Method: We included patients from the CERERRA international cohort receiving the first treatment cycle with available smoking status (n = 2481, smokers n = 528, non-current smokers n = 1953) and at least one follow-up visit. Outcome measures were change in Disease Activity Score based on 28-joint count (Delta DAS28) and European League Against Rheumatism (EULAR) good response at 6 months, with non-current smokers as the referent group. Results: Compared with non-smokers at baseline, smokers were more often rheumatoid factor (RF)/anti-citrullinated protein antibody (ACPA) positive and males, had shorter disease duration, lower DAS28 and Health Assessment Questionnaire (HAQ) score, a higher number of prior biological disease-modifying anti-rheumatic drugs, and were more likely to receive concomitant conventional synthetic disease-modifying anti-rheumatic drug (csDMARDs). Disease activity had decreased less in smokers at 6 months (Delta DAS28 = 1.5 vs 1.7, p = 0.006), although the difference was no longer significant after correction for baseline DAS28 (p = 0.41). EULAR good response rates did not differ between smokers and non-smokers overall or stratified by RF/ACPA status, although smokers had lower good response rates among seronegative patients (ACPA-negative: 6% vs 14%, RF-negative: 11% vs 18%). Smoking did not predict good response [odds ratio (OR) = 1.04, 95% confidence interval (CI) = 0.76-1.41], while ACPA, DAS28, HAQ, and concomitant csDMARDs were significant predictors for good response. However, when stratified by country, smokers were less likely to achieve good response in Sweden (unadjusted OR = 0.24, 95% CI = 0.07-0.89), and a trend was seen in the Czech Republic (OR = 0.45, 95% CI = 0.16-1.02). Conclusion: In this large, observational, multinational RA cohort, smokers starting RTX differed from non-smokers by having shorter disease duration and lower disease activity, but more previous treatments. The overall results do not support smoking as an important predictor for response to RTX in patients with RA.
Avainsanat: CIGARETTE-SMOKING
RADIOGRAPHIC PROGRESSION
DOUBLE-BLIND
EFFICACY
SAFETY
METHOTREXATE
THERAPY
TRIAL
3121 General medicine, internal medicine and other clinical medicine
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