Bente Glintborg1, Pil Højgaard2, Merete Lund Hetland3, Niels Steen Krogh4, Gina Kollerup5, Jørgen Jensen6, Stavros Chrysidis7, Inger Marie Jensen Hansen8, Mette Holland-Fischer9, Torben Højland Hansen10, Christine Nilsson11, Jakob Espesen12, Henrik Nordin6, Anne Gitte Rasmussen Loft13, Randi Pelck14, Tove Lorenzen15, Sussi Flejsborg Oeftiger16, Barbara Unger17, Frank Jaeger18, Peter Mosborg Petersen19, Claus Rasmussen20, Lene Dreyer2. 1. Department of Rheumatology, Gentofte University Hospital, Copenhagen, Denmark, The Danish Rheumatologic Database, Rigshospitalet, Glostrup Hospital, Glostrup, Denmark, glintborg@dadlnet.dk. 2. Department of Rheumatology, Gentofte University Hospital, Copenhagen, Denmark. 3. The Danish Rheumatologic Database, Rigshospitalet, Glostrup Hospital, Glostrup, Denmark, Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup Hospital, Glostrup, Denmark, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark' 4. Zitelab Aps, Copenhagen, Denmark. 5. Department of Rheumatology, Frederiksberg Hospital, Frederiksberg, Denmark. 6. Department of Rheumatology, Rigshospitalet, Glostrup Hospital, Glostrup, Denmark. 7. Department of Rheumatology, Esbjerg Hospital, Esbjerg, Denmark. 8. Department of Rheumatology, Svendborg Hospital, Svendborg, Denmark. 9. Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark. 10. Department of Rheumatology, Holbæk Hospital, Holbæk, Denmark. 11. Department of Rheumatology, Odense University Hospital, Odense, Denmark. 12. Department of Rheumatology, Vejle Hospital, Vejle, Denmark. 13. Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark. 14. Department of Rheumatology, Køge Hospital, Køge, Denmark. 15. Department of Rheumatology, Silkeborg University Hospital, Silkeborg, Denmark. 16. Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark. 17. Department of Rheumatology, Horsens Hospital, Horsens, Denmark. 18. Department of Rheumatology, Holstebro Hospital, Holstebro, Denmark. 19. Department of Rheumatology, Randers Hospital, Randers, Denmark and. 20. Department of Rheumatology, Sygehus Vendsyssel, Hjørring, Denmark.
Abstract
OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses in patients with AS treated with their first tumour necrosis factor-alpha inhibitor (TNFi) therapy in routine care. METHODS: Observational cohort study based on the Danish nationwide DANBIO registry. Kaplan-Meier plots, Cox and logistic regression analyses by smoking status (current/never/previous) were calculated for treatment adherence and BASDAI 50%/20 mm-response. Additional stratified analyses were performed for gender and TNFi-type. RESULTS: Of 1576 AS patients included in the study, 1425(90%) had known smoking status (current/never/previous: 43%/41%/16%). The median follow-up time was 2.02 years (IQR 0.69-5.01). At baseline, current smokers compared with never smokers had longer disease duration (4 years (1-12)/2 years (0-10)), higher BASDAI (61 mm (47-73)/58 mm (44-70)), BASFI (53 mm (35-69)/46 mm (31-66)) and BASMI (40 mm (20-60)/30 mm (10-50)) scores (all P < 0.01). Current and previous smokers had shorter treatment adherence than never smokers (current: 2.30 years (1.81-2.79) (median (95% CI)); previous: 2.48 years (1.56-3.40), never: 4.12 years (3.29-4.95)), P < 0.0001). Similar results were found in multivariate analyses (current versus never smokers, HR 1.41 (95% CI 1.21-1.65), P < 0.001), most pronounced among men. Current smokers had poorer 6 months' BASDAI50%/20 mm-response rate than never smokers (42%/58%, P < 0.001). In multivariate analyses, current smokers had lower odds of achieving BASDAI50%/20 mm-response than never smokers, both overall (OR 0.48 (95% CI 0.35-0.65), P < 0.0001) and for the different TNFi-types (adalimumab 0.45 (0.27-0.76)/etanercept 0.24 (0.10-0.61)/infliximab 0.57 (0.34-0.95)). CONCLUSION: In this study of TNFi-treated AS patients in clinical practice, current and previous smokers had significantly poorer patient-reported outcomes at baseline, shorter treatment adherence and poorer treatment response compared with never smokers.
OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses in patients with AS treated with their first tumour necrosis factor-alpha inhibitor (TNFi) therapy in routine care. METHODS: Observational cohort study based on the Danish nationwide DANBIO registry. Kaplan-Meier plots, Cox and logistic regression analyses by smoking status (current/never/previous) were calculated for treatment adherence and BASDAI 50%/20 mm-response. Additional stratified analyses were performed for gender and TNFi-type. RESULTS: Of 1576 AS patients included in the study, 1425(90%) had known smoking status (current/never/previous: 43%/41%/16%). The median follow-up time was 2.02 years (IQR 0.69-5.01). At baseline, current smokers compared with never smokers had longer disease duration (4 years (1-12)/2 years (0-10)), higher BASDAI (61 mm (47-73)/58 mm (44-70)), BASFI (53 mm (35-69)/46 mm (31-66)) and BASMI (40 mm (20-60)/30 mm (10-50)) scores (all P < 0.01). Current and previous smokers had shorter treatment adherence than never smokers (current: 2.30 years (1.81-2.79) (median (95% CI)); previous: 2.48 years (1.56-3.40), never: 4.12 years (3.29-4.95)), P < 0.0001). Similar results were found in multivariate analyses (current versus never smokers, HR 1.41 (95% CI 1.21-1.65), P < 0.001), most pronounced among men. Current smokers had poorer 6 months' BASDAI50%/20 mm-response rate than never smokers (42%/58%, P < 0.001). In multivariate analyses, current smokers had lower odds of achieving BASDAI50%/20 mm-response than never smokers, both overall (OR 0.48 (95% CI 0.35-0.65), P < 0.0001) and for the different TNFi-types (adalimumab 0.45 (0.27-0.76)/etanercept 0.24 (0.10-0.61)/infliximab 0.57 (0.34-0.95)). CONCLUSION: In this study of TNFi-treated AS patients in clinical practice, current and previous smokers had significantly poorer patient-reported outcomes at baseline, shorter treatment adherence and poorer treatment response compared with never smokers.
Authors: Sizheng Steven Zhao; Kazuki Yoshida; Gareth T Jones; David M Hughes; Sara K Tedeschi; Houchen Lyu; Robert J Moots; Daniel H Solomon; Nicola J Goodson Journal: Arthritis Care Res (Hoboken) Date: 2020-03-12 Impact factor: 4.794
Authors: U Kiltz; J Braun; A Becker; J-F Chenot; M Dreimann; L Hammel; A Heiligenhaus; K-G Hermann; R Klett; D Krause; K-F Kreitner; U Lange; A Lauterbach; W Mau; R Mössner; U Oberschelp; S Philipp; U Pleyer; M Rudwaleit; E Schneider; T L Schulte; J Sieper; A Stallmach; B Swoboda; M Winking Journal: Z Rheumatol Date: 2019-12 Impact factor: 1.372
Authors: Ida K Roelsgaard; Bente A Esbensen; Mikkel Østergaard; Silvia Rollefstad; Anne G Semb; Robin Christensen; Thordis Thomsen Journal: Cochrane Database Syst Rev Date: 2019-09-02