The impact of smoking on response to tumor necrosis factor-α inhibitor treatment in patients with ankylosing spondylitis
BACKGROUND: To investigate the impact of smoking on disease activity, treatment retention, and response in patients with ankylosing spondylitis (AS) treated with their first tumor necrosis factor-α inhibitor (TNFi).
METHODS: AS patients who started their first TNFi treatment for the active axial disease (BASDAI ≥ 4) from TURKBIO Registry were included. Treatment response of smoker (current and ex-smokers) and nonsmoker (never smoker) patients were primarily evaluated as achievement of BASDAI50 or improvement in BASDAI at least 20 mm at 3 months and 6 months compared to baseline.
RESULTS: There were 322 patients with AS (60% male, 59% smoker, mean age: 38.3 years). The median follow-up time was 2.8 years (Q1- Q3: 1.3-3.8), and disease duration was 3.5 years (Q1-Q3: 0.7-8.2). Smokers had male predominance (p < 0.001), lower ESR (p = 0.03), higher BASDAI (p = 0.02), BASFI (p = 0.05), HAQ-AS (p = 0.007), and ASDAS-CRP (p = 0.04) compared with nonsmokers at baseline. In the multivariate analysis, male gender [OR 2.7 (95%CI 1.4-5), p = 0.002], and concomitant conventional synthetic disease-modifying antirheumatic drug use [OR 2.4 (95%CI 1.1-5.2), p = 0.03] were associated with better treatment response. There was an association of male gender [HR 2.4 (95%CI 1.6-3.7), p < 0.001], older age (≥30years) [HR 1.8 (95%CI 1.1-2.8), p = 0.01], and response to treatment [HR 1.8 (95%CI 1.2-2.9), p = 0.008] with better treatment retention. No impact of smoking status was found on treatment retention and response in univariate and multivariate analyses.
DISCUSSION: This study suggested that smoking was associated with poorer patient-reported outcomes in biologic naïve AS patients initiating their first TNFi treatment, but it had no impact on the TNFi treatment response and retention rate.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:53 |
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| Enthalten in: |
Turkish journal of medical sciences - 53(2023), 4 vom: 31. Aug., Seite 970-978 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tuğsal, Handan Yarkan [VerfasserIn] |
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| Links: |
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| Themen: |
Ankylosing spondylitis |
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| Anmerkungen: |
Date Completed 01.12.2023 Date Revised 04.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.55730/1300-0144.5661 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 100 | 1 | |a Tuğsal, Handan Yarkan |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of smoking on response to tumor necrosis factor-α inhibitor treatment in patients with ankylosing spondylitis |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 01.12.2023 | ||
| 500 | |a Date Revised 04.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: To investigate the impact of smoking on disease activity, treatment retention, and response in patients with ankylosing spondylitis (AS) treated with their first tumor necrosis factor-α inhibitor (TNFi) | ||
| 520 | |a METHODS: AS patients who started their first TNFi treatment for the active axial disease (BASDAI ≥ 4) from TURKBIO Registry were included. Treatment response of smoker (current and ex-smokers) and nonsmoker (never smoker) patients were primarily evaluated as achievement of BASDAI50 or improvement in BASDAI at least 20 mm at 3 months and 6 months compared to baseline | ||
| 520 | |a RESULTS: There were 322 patients with AS (60% male, 59% smoker, mean age: 38.3 years). The median follow-up time was 2.8 years (Q1- Q3: 1.3-3.8), and disease duration was 3.5 years (Q1-Q3: 0.7-8.2). Smokers had male predominance (p < 0.001), lower ESR (p = 0.03), higher BASDAI (p = 0.02), BASFI (p = 0.05), HAQ-AS (p = 0.007), and ASDAS-CRP (p = 0.04) compared with nonsmokers at baseline. In the multivariate analysis, male gender [OR 2.7 (95%CI 1.4-5), p = 0.002], and concomitant conventional synthetic disease-modifying antirheumatic drug use [OR 2.4 (95%CI 1.1-5.2), p = 0.03] were associated with better treatment response. There was an association of male gender [HR 2.4 (95%CI 1.6-3.7), p < 0.001], older age (≥30years) [HR 1.8 (95%CI 1.1-2.8), p = 0.01], and response to treatment [HR 1.8 (95%CI 1.2-2.9), p = 0.008] with better treatment retention. No impact of smoking status was found on treatment retention and response in univariate and multivariate analyses | ||
| 520 | |a DISCUSSION: This study suggested that smoking was associated with poorer patient-reported outcomes in biologic naïve AS patients initiating their first TNFi treatment, but it had no impact on the TNFi treatment response and retention rate | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a treatment response | |
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| 650 | 7 | |a Tumor Necrosis Factor-alpha |2 NLM | |
| 650 | 7 | |a Antirheumatic Agents |2 NLM | |
| 650 | 7 | |a Immunologic Factors |2 NLM | |
| 700 | 1 | |a Artin, Gökçe Kenar |e verfasserin |4 aut | |
| 700 | 1 | |a Can, Gerçek |e verfasserin |4 aut | |
| 700 | 1 | |a Çapar, Sedat |e verfasserin |4 aut | |
| 700 | 1 | |a Zengin, Berrin |e verfasserin |4 aut | |
| 700 | 1 | |a Akar, Servet |e verfasserin |4 aut | |
| 700 | 1 | |a Dalkiliç, Hüseyin Ediz |e verfasserin |4 aut | |
| 700 | 1 | |a Şenel, Abdurrahman Soner |e verfasserin |4 aut | |
| 700 | 1 | |a Koca, Süleyman Serdar |e verfasserin |4 aut | |
| 700 | 1 | |a Göker, Berna |e verfasserin |4 aut | |
| 700 | 1 | |a Yazici, Ayten |e verfasserin |4 aut | |
| 700 | 1 | |a İnanç, Güzide Nevsun |e verfasserin |4 aut | |
| 700 | 1 | |a Ellidokuz, Hülya |e verfasserin |4 aut | |
| 700 | 1 | |a Akkoç, Nurullah |e verfasserin |4 aut | |
| 700 | 1 | |a Önen, Fatoş |e verfasserin |4 aut | |
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