TY - JOUR
T1 - Effects of smoking on clinical treatment outcomes amongst patients with chronic inflammatory diseases initiating biologics
T2 - secondary analyses of the prospective BELIEVE cohort study
AU - Larsen, Maja Graves Rosenkilde
AU - Overgaard, Silja Hvid
AU - Petersen, Sofie Ronja
AU - Møllegaard, Karen Mai
AU - Munk, Heidi Lausten
AU - Nexøe, Anders Bathum
AU - Glerup, Henning
AU - Guldmann, Tanja
AU - Pedersen, Natalia
AU - Saboori, Sanaz
AU - Dahlerup, Jens Frederik
AU - Hvas, Christian Lodberg
AU - Andersen, Karina Winther
AU - Jawhara, Mohamad
AU - Haagen Nielsen, Ole
AU - Bergenheim, Fredrik Olof
AU - Brodersen, Jacob Broder
AU - Bygum, Anette
AU - Ellingsen, Torkell
AU - Kjeldsen, Jens
AU - Christensen, Robin
AU - Andersen, Vibeke
PY - 2024/9
Y1 - 2024/9
N2 - The prevalence and disease burden of chronic inflammatory diseases (CIDs) are predicted to rise. Patients are commonly treated with biological agents, but the individual treatment responses vary, warranting further research into optimizing treatment strategies. This study aimed to compare the clinical treatment responses in patients with CIDs initiating biologic therapy based on smoking status, a notorious risk factor in CIDs. In this multicentre cohort study including 233 patients with a diagnosis of Crohn's disease, ulcerative colitis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis or psoriasis initiating biologic therapy, we compared treatment response rates after 14 to 16 weeks and secondary outcomes between smokers and non-smokers. We evaluated the contrast between groups using logistic regression models: (i) a “crude” model, only adjusted for the CID type, and (ii) an adjusted model (including sex and age). Among the 205 patients eligible for this study, 53 (26%) were smokers. The treatment response rate among smokers (n = 23 [43%]) was lower compared to the non-smoking CID population (n = 92 [61%]), corresponding to a “crude” OR of 0.51 (95% CI: [0.26;1.01]) while adjusting for sex and age resulted in consistent findings: 0.51 [0.26;1.02]. The contrast was apparently most prominent among the 38 RA patients, with significantly lower treatment response rates for smokers in both the “crude” and adjusted models (adjusted OR 0.13, [0.02;0.81]). Despite a significant risk of residual confounding, patients with CIDs (rheumatoid arthritis in particular) should be informed that smoking probably lowers the odds of responding sufficiently to biological therapy. Registration: Clinical.Trials.gov NCT03173144.
AB - The prevalence and disease burden of chronic inflammatory diseases (CIDs) are predicted to rise. Patients are commonly treated with biological agents, but the individual treatment responses vary, warranting further research into optimizing treatment strategies. This study aimed to compare the clinical treatment responses in patients with CIDs initiating biologic therapy based on smoking status, a notorious risk factor in CIDs. In this multicentre cohort study including 233 patients with a diagnosis of Crohn's disease, ulcerative colitis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis or psoriasis initiating biologic therapy, we compared treatment response rates after 14 to 16 weeks and secondary outcomes between smokers and non-smokers. We evaluated the contrast between groups using logistic regression models: (i) a “crude” model, only adjusted for the CID type, and (ii) an adjusted model (including sex and age). Among the 205 patients eligible for this study, 53 (26%) were smokers. The treatment response rate among smokers (n = 23 [43%]) was lower compared to the non-smoking CID population (n = 92 [61%]), corresponding to a “crude” OR of 0.51 (95% CI: [0.26;1.01]) while adjusting for sex and age resulted in consistent findings: 0.51 [0.26;1.02]. The contrast was apparently most prominent among the 38 RA patients, with significantly lower treatment response rates for smokers in both the “crude” and adjusted models (adjusted OR 0.13, [0.02;0.81]). Despite a significant risk of residual confounding, patients with CIDs (rheumatoid arthritis in particular) should be informed that smoking probably lowers the odds of responding sufficiently to biological therapy. Registration: Clinical.Trials.gov NCT03173144.
KW - biologic therapy
KW - chronic inflammatory disease
KW - smoking
KW - Prospective Studies
KW - Humans
KW - Middle Aged
KW - Psoriasis/drug therapy
KW - Male
KW - Treatment Outcome
KW - Arthritis, Rheumatoid/drug therapy
KW - Inflammation
KW - Smoking/adverse effects
KW - Biological Products/therapeutic use
KW - Arthritis, Psoriatic/drug therapy
KW - Crohn Disease/drug therapy
KW - Colitis, Ulcerative/drug therapy
KW - Female
KW - Adult
KW - Aged
KW - Chronic Disease
KW - Cohort Studies
U2 - 10.1111/sji.13395
DO - 10.1111/sji.13395
M3 - Journal article
C2 - 38973149
AN - SCOPUS:85197661324
SN - 0300-9475
VL - 100
JO - Scandinavian Journal of Immunology
JF - Scandinavian Journal of Immunology
IS - 3
M1 - e13395
ER -