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

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dc.contributor University of Helsinki, University Management en 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. 2019-01-22T09:02:01Z 2019-01-22T09:02:01Z 2019-01-02
dc.identifier.citation 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 . en
dc.identifier.issn 0300-9742
dc.identifier.other PURE: 121489135
dc.identifier.other PURE UUID: 3b498489-69ae-4258-969c-774787265c13
dc.identifier.other WOS: 000454659800003
dc.identifier.other Scopus: 85053926648
dc.description.abstract 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. en
dc.format.extent 7
dc.language.iso eng
dc.relation.ispartof Scandinavian Journal of Rheumatology
dc.rights en
dc.subject DOUBLE-BLIND en
dc.subject EFFICACY en
dc.subject SAFETY en
dc.subject METHOTREXATE en
dc.subject THERAPY en
dc.subject TRIAL en
dc.subject 3121 General medicine, internal medicine and other clinical medicine en
dc.title Smoking and response to rituximab in rheumatoid arthritis : results from an international European collaboration en
dc.type Article
dc.description.version Peer reviewed
dc.type.uri info:eu-repo/semantics/other
dc.type.uri info:eu-repo/semantics/publishedVersion

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