Association between tobacco smoking and response to tumour necrosis factor α inhibitor treatment in psoriatic arthritis

results from the DANBIO registry

Pil Højgaard, Bente Glintborg, Merete Lund Hetland, Torben Højland Hansen, Philip Rask Lage-Hansen , Martin H Petersen, Mette Holland-Fischer, Christine Nilsson, Anne Gitte Loft, Bjarne Nesgaard Andersen, Thomas Adelsten, Jørgen Jensen, Emina Omerovic, Regitse Christensen, Ulrik Tarp, René Østgård, Lene Dreyer

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses among patients with psoriatic arthritis (PsA) initiating the first tumour necrosis factor α inhibitor therapy (TNFi) in routine care.

METHODS: Observational cohort study based on the Danish nationwide DANBIO registry. Kaplan-Meier plots, logistic and Cox regression analyses by smoking status (current/previous/never smoker) were calculated for treatment adherence, ACR20/50/70-responses and EULAR-good-response. Additional stratified analyses were performed according to gender and TNFi-subtype (adalimumab/etanercept/infliximab).

RESULTS: Among 1388 PsA patients included in the study, 1148 (83%) had known smoking status (33% current, 41% never and 26% previous smokers). Median follow-up time was 1.22 years (IQR 0.44-2.96). At baseline, current smokers had lower Body Mass Index (27 kg/m(2) (23-30)/28 kg/m(2) (24-31)) (median (IQR)), shorter disease duration (3 years (1-8)/5 years (2-10)), lower swollen joint count (2 (0-5)/3 (1-6)), higher visual-analogue-scale (VAS) patient global (72 mm (54-87)/68 mm (50-80)), VAS fatigue (72 mm (51-86)/63 mm (40-77)) and Health Assessment Questionnaire (HAQ) score (1.1 (0.7 to 1.5)/1.0 (0.5 to 1.5)) than never smokers (all p<0.05). Current smokers had shorter treatment adherence than never smokers (1.56 years (0.97 to 2.15)/2.43 years (1.88 to 2.97), (median (95% CI)), log rank p=0.02) and poorer 6 months' EULAR-good-response rates (23%/34%), ACR20 (24%/33%) and ACR50 response rates (17%/24%) (all p<0.05), most pronounced in men. In current smokers, the treatment adherence was poorer for infliximab (HR) 1.62, 95% CI 1.06 to 2.48) and etanercept (HR 1.74, 1.14 to 2.66) compared to never smokers, but not for adalimumab (HR 0.80, 0.52 to 1.23).

CONCLUSION: In PsA, smokers had worse baseline patient-reported outcomes, shorter treatment adherence and poorer response to TNFi's compared to non-smokers. This was most pronounced in men and in patients treated with infliximab or etanercept.

OriginalsprogEngelsk
TidsskriftAnnals of the Rheumatic Diseases
Vol/bind74
Udgave nummer12
Sider (fra-til)2130-2136
ISSN0003-4967
DOI
StatusUdgivet - dec. 2015

Fingeraftryk

Psoriatic Arthritis
Tobacco
Registries
Tumor Necrosis Factor-alpha
Smoking
Logistics
Visual Analog Scale
Health
Fatigue of materials
Infliximab
Etanercept
Body Mass Index
Cohort Studies
Adalimumab
Joints
Logistic Models
Regression Analysis

Citer dette

Højgaard, Pil ; Glintborg, Bente ; Hetland, Merete Lund ; Hansen, Torben Højland ; Rask Lage-Hansen , Philip ; Petersen, Martin H ; Holland-Fischer, Mette ; Nilsson, Christine ; Loft, Anne Gitte ; Andersen, Bjarne Nesgaard ; Adelsten, Thomas ; Jensen, Jørgen ; Omerovic, Emina ; Christensen, Regitse ; Tarp, Ulrik ; Østgård, René ; Dreyer, Lene. / Association between tobacco smoking and response to tumour necrosis factor α inhibitor treatment in psoriatic arthritis : results from the DANBIO registry. I: Annals of the Rheumatic Diseases. 2015 ; Bind 74, Nr. 12. s. 2130-2136.
@article{585f8e31c68a43989f0dea441f7941a3,
title = "Association between tobacco smoking and response to tumour necrosis factor α inhibitor treatment in psoriatic arthritis: results from the DANBIO registry",
abstract = "OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses among patients with psoriatic arthritis (PsA) initiating the first tumour necrosis factor α inhibitor therapy (TNFi) in routine care.METHODS: Observational cohort study based on the Danish nationwide DANBIO registry. Kaplan-Meier plots, logistic and Cox regression analyses by smoking status (current/previous/never smoker) were calculated for treatment adherence, ACR20/50/70-responses and EULAR-good-response. Additional stratified analyses were performed according to gender and TNFi-subtype (adalimumab/etanercept/infliximab).RESULTS: Among 1388 PsA patients included in the study, 1148 (83{\%}) had known smoking status (33{\%} current, 41{\%} never and 26{\%} previous smokers). Median follow-up time was 1.22 years (IQR 0.44-2.96). At baseline, current smokers had lower Body Mass Index (27 kg/m(2) (23-30)/28 kg/m(2) (24-31)) (median (IQR)), shorter disease duration (3 years (1-8)/5 years (2-10)), lower swollen joint count (2 (0-5)/3 (1-6)), higher visual-analogue-scale (VAS) patient global (72 mm (54-87)/68 mm (50-80)), VAS fatigue (72 mm (51-86)/63 mm (40-77)) and Health Assessment Questionnaire (HAQ) score (1.1 (0.7 to 1.5)/1.0 (0.5 to 1.5)) than never smokers (all p<0.05). Current smokers had shorter treatment adherence than never smokers (1.56 years (0.97 to 2.15)/2.43 years (1.88 to 2.97), (median (95{\%} CI)), log rank p=0.02) and poorer 6 months' EULAR-good-response rates (23{\%}/34{\%}), ACR20 (24{\%}/33{\%}) and ACR50 response rates (17{\%}/24{\%}) (all p<0.05), most pronounced in men. In current smokers, the treatment adherence was poorer for infliximab (HR) 1.62, 95{\%} CI 1.06 to 2.48) and etanercept (HR 1.74, 1.14 to 2.66) compared to never smokers, but not for adalimumab (HR 0.80, 0.52 to 1.23).CONCLUSION: In PsA, smokers had worse baseline patient-reported outcomes, shorter treatment adherence and poorer response to TNFi's compared to non-smokers. This was most pronounced in men and in patients treated with infliximab or etanercept.",
author = "Pil H{\o}jgaard and Bente Glintborg and Hetland, {Merete Lund} and Hansen, {Torben H{\o}jland} and {Rask Lage-Hansen}, Philip and Petersen, {Martin H} and Mette Holland-Fischer and Christine Nilsson and Loft, {Anne Gitte} and Andersen, {Bjarne Nesgaard} and Thomas Adelsten and J{\o}rgen Jensen and Emina Omerovic and Regitse Christensen and Ulrik Tarp and Ren{\'e} {\O}stg{\aa}rd and Lene Dreyer",
note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",
year = "2015",
month = "12",
doi = "10.1136/annrheumdis-2014-205389",
language = "English",
volume = "74",
pages = "2130--2136",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "B M J Group",
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Højgaard, P, Glintborg, B, Hetland, ML, Hansen, TH, Rask Lage-Hansen , P, Petersen, MH, Holland-Fischer, M, Nilsson, C, Loft, AG, Andersen, BN, Adelsten, T, Jensen, J, Omerovic, E, Christensen, R, Tarp, U, Østgård, R & Dreyer, L 2015, 'Association between tobacco smoking and response to tumour necrosis factor α inhibitor treatment in psoriatic arthritis: results from the DANBIO registry', Annals of the Rheumatic Diseases, bind 74, nr. 12, s. 2130-2136. https://doi.org/10.1136/annrheumdis-2014-205389

Association between tobacco smoking and response to tumour necrosis factor α inhibitor treatment in psoriatic arthritis : results from the DANBIO registry. / Højgaard, Pil; Glintborg, Bente; Hetland, Merete Lund; Hansen, Torben Højland; Rask Lage-Hansen , Philip; Petersen, Martin H; Holland-Fischer, Mette; Nilsson, Christine; Loft, Anne Gitte; Andersen, Bjarne Nesgaard; Adelsten, Thomas; Jensen, Jørgen; Omerovic, Emina; Christensen, Regitse; Tarp, Ulrik; Østgård, René; Dreyer, Lene.

I: Annals of the Rheumatic Diseases, Bind 74, Nr. 12, 12.2015, s. 2130-2136.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Association between tobacco smoking and response to tumour necrosis factor α inhibitor treatment in psoriatic arthritis

T2 - results from the DANBIO registry

AU - Højgaard, Pil

AU - Glintborg, Bente

AU - Hetland, Merete Lund

AU - Hansen, Torben Højland

AU - Rask Lage-Hansen , Philip

AU - Petersen, Martin H

AU - Holland-Fischer, Mette

AU - Nilsson, Christine

AU - Loft, Anne Gitte

AU - Andersen, Bjarne Nesgaard

AU - Adelsten, Thomas

AU - Jensen, Jørgen

AU - Omerovic, Emina

AU - Christensen, Regitse

AU - Tarp, Ulrik

AU - Østgård, René

AU - Dreyer, Lene

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2015/12

Y1 - 2015/12

N2 - OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses among patients with psoriatic arthritis (PsA) initiating the first tumour necrosis factor α inhibitor therapy (TNFi) in routine care.METHODS: Observational cohort study based on the Danish nationwide DANBIO registry. Kaplan-Meier plots, logistic and Cox regression analyses by smoking status (current/previous/never smoker) were calculated for treatment adherence, ACR20/50/70-responses and EULAR-good-response. Additional stratified analyses were performed according to gender and TNFi-subtype (adalimumab/etanercept/infliximab).RESULTS: Among 1388 PsA patients included in the study, 1148 (83%) had known smoking status (33% current, 41% never and 26% previous smokers). Median follow-up time was 1.22 years (IQR 0.44-2.96). At baseline, current smokers had lower Body Mass Index (27 kg/m(2) (23-30)/28 kg/m(2) (24-31)) (median (IQR)), shorter disease duration (3 years (1-8)/5 years (2-10)), lower swollen joint count (2 (0-5)/3 (1-6)), higher visual-analogue-scale (VAS) patient global (72 mm (54-87)/68 mm (50-80)), VAS fatigue (72 mm (51-86)/63 mm (40-77)) and Health Assessment Questionnaire (HAQ) score (1.1 (0.7 to 1.5)/1.0 (0.5 to 1.5)) than never smokers (all p<0.05). Current smokers had shorter treatment adherence than never smokers (1.56 years (0.97 to 2.15)/2.43 years (1.88 to 2.97), (median (95% CI)), log rank p=0.02) and poorer 6 months' EULAR-good-response rates (23%/34%), ACR20 (24%/33%) and ACR50 response rates (17%/24%) (all p<0.05), most pronounced in men. In current smokers, the treatment adherence was poorer for infliximab (HR) 1.62, 95% CI 1.06 to 2.48) and etanercept (HR 1.74, 1.14 to 2.66) compared to never smokers, but not for adalimumab (HR 0.80, 0.52 to 1.23).CONCLUSION: In PsA, smokers had worse baseline patient-reported outcomes, shorter treatment adherence and poorer response to TNFi's compared to non-smokers. This was most pronounced in men and in patients treated with infliximab or etanercept.

AB - OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses among patients with psoriatic arthritis (PsA) initiating the first tumour necrosis factor α inhibitor therapy (TNFi) in routine care.METHODS: Observational cohort study based on the Danish nationwide DANBIO registry. Kaplan-Meier plots, logistic and Cox regression analyses by smoking status (current/previous/never smoker) were calculated for treatment adherence, ACR20/50/70-responses and EULAR-good-response. Additional stratified analyses were performed according to gender and TNFi-subtype (adalimumab/etanercept/infliximab).RESULTS: Among 1388 PsA patients included in the study, 1148 (83%) had known smoking status (33% current, 41% never and 26% previous smokers). Median follow-up time was 1.22 years (IQR 0.44-2.96). At baseline, current smokers had lower Body Mass Index (27 kg/m(2) (23-30)/28 kg/m(2) (24-31)) (median (IQR)), shorter disease duration (3 years (1-8)/5 years (2-10)), lower swollen joint count (2 (0-5)/3 (1-6)), higher visual-analogue-scale (VAS) patient global (72 mm (54-87)/68 mm (50-80)), VAS fatigue (72 mm (51-86)/63 mm (40-77)) and Health Assessment Questionnaire (HAQ) score (1.1 (0.7 to 1.5)/1.0 (0.5 to 1.5)) than never smokers (all p<0.05). Current smokers had shorter treatment adherence than never smokers (1.56 years (0.97 to 2.15)/2.43 years (1.88 to 2.97), (median (95% CI)), log rank p=0.02) and poorer 6 months' EULAR-good-response rates (23%/34%), ACR20 (24%/33%) and ACR50 response rates (17%/24%) (all p<0.05), most pronounced in men. In current smokers, the treatment adherence was poorer for infliximab (HR) 1.62, 95% CI 1.06 to 2.48) and etanercept (HR 1.74, 1.14 to 2.66) compared to never smokers, but not for adalimumab (HR 0.80, 0.52 to 1.23).CONCLUSION: In PsA, smokers had worse baseline patient-reported outcomes, shorter treatment adherence and poorer response to TNFi's compared to non-smokers. This was most pronounced in men and in patients treated with infliximab or etanercept.

U2 - 10.1136/annrheumdis-2014-205389

DO - 10.1136/annrheumdis-2014-205389

M3 - Journal article

VL - 74

SP - 2130

EP - 2136

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 12

ER -