Navigation Links
Current smokers with early rheumatoid arthritis less responsive to TNF inhibitors, methotrexate
Date:1/4/2011

Patients with early rheumatoid arthritis (RA) who are current smokers were less likely to achieve good response to methotrexate (MTX) and tumor necrosis factor (TNF) inhibitors than those who never smoked. The study by researchers from Sweden also found that RA patients who smoked in the past did not experience a lower response to these therapies. Results of the 10-year study appear in the January 2011 issue of Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

According to the World Health Organization (WHO), approximately 0.8% of adults (age 15 and older) worldwide have RAa chronic autoimmune disease characterized by inflammation, pain, and swelling in the joints. Current medical evidence points to smoking as a known risk factor for RA development and globally, WHO estimates there are more than one billion smokers. However limited data are available on the impact of cigarette smoking and response to pharmacological therapy in early RA.

In the current study, Saedis Saevarsdottir, MD, PhD and colleagues from Karolinska University Hospital and Karolinska Institute in Stockholm investigated the influence cigarette smoking has on response to MTX and TNF inhibitor treatment in early RA. The team used clinical data for 1430 patients entering the epidemiological investigation of rheumatoid arthritis (EIRA) between 1996 and 2006. EIRA is a population-based case-control study in Sweden comprising RA patients between the ages of 18 and 70, who were enrolled on average 10 months from symptom onset. Of the participants, 873 started MTX monotherapy upon entering EIRA, and 535 started TNF inhibitor therapy, on average 3 years after the diagnosis.

Results indicated that at three months following the start of MTX current smokers were less likely to achieve a EULAR "good response"1 compared to those who never smoked (27% vs. 36%); (29% vs. 43%) following the start of TNF inhibitors. Researchers evaluated the entire cohort for all treatments used and found current smoking was associated with less chance of a good response (odds ratio for 3 months = 0.61, 6 months = 0.65, 1 year = 0.78, 2 years = 0.66, 5 years = 0.61). Past smoking history did not affect the patients' response to MTX or TNF inhibitors.

"We also found that only 14% of current smokers who did not start any disease modifying treatment at baseline reached the good response category after 3 months, compared to 34% of RA patients who never smoked," confirmed Dr. Saevarsdottir. The authors recommend further studies to determine if discontinuation of smoking prior to initiating treatment would be beneficial. Dr. Saevarsdottir concluded, "Our findings provide strong evidence that clinicians should include smoking cessation programs as part of their standard therapeutic arsenal in caring for patients with RA."

1 In accordance with recent guidelines from the European League against Rheumatism (EULAR) and the ACR, the study team used the EULAR response criteria, based on the 28-joint disease activity score (DAS28), to define response to treatment with "good response" considered a DAS28 less than 3.2 at the follow-up visit and greater than 1.2 units decrease compared to the baseline DAS28.


'/>"/>

Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Children can have recurrent strokes
2. Mesothelioma Clinical Trials List Offered by IQ Mesothelioma: Search Current Mesothelioma Treatment Options
3. Current Blood Thinners Face Tough Competition
4. New study introduces the prospect for concurrent antiangiogenic/antitumorigenic therapy
5. Autism Consortium study in Pediatrics shows CMA finds more genetic abnormalities than current tests
6. Lakeside Medical Group, Heritage Provider Network, CEO Dr. Richard Merkin, Featured on Several Segments of Fox National News and Fox Business Channel on Current Healthcare Payment Structures to Physicians
7. Minnesota Special Registration Review of Atrazine Found Current Regulations are Protective
8. Well-tolerated radiotherapy provides longer life to patients with recurrent brain cancer
9. New Online Fire Officer and Hazmat Courses Focused On Keeping Skills Current
10. Molecular imaging detects recurrent prostate cancer
11. Knowledge translation keeps treatment current
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... ... (SOP) alumni Hannah Randall, PharmD ‘17, and Jennifer Huggins, PharmD ’17, along ... updates for the primary prevention of cardiovascular diseases during the 15th Annual ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... Ellevate Network, ... in business to advocate for action towards gender equality at their inaugural Summit in ... around the globe, and reached a social audience of over 3 million. To watch ...
(Date:10/13/2017)... ... October 13, 2017 , ... “The Journey: From the Mountains to the ... save lost souls in the Philippines. “The Journey: From the Mountains to the Mission ... of the Bible. She has taught all ages and currently teaches a class of ...
(Date:10/12/2017)... WAUSAU, Wis. (PRWEB) , ... October 12, 2017 ... ... formulated standard products to meet the demand of today’s consumer and regulatory authorities ... team of probiotic experts and tested to meet the highest standard. , ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... ... Mohebi Hair Restoration, has recently contributed a medical article to the newly revamped ... cosmetictown.com. Dr. Mohebi’s article spotlights the hair transplant procedure known as Follicular ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... Divoti USA will engrave and process all non-coated stainless ... FDA requirements, which stipulates new criteria regarding medical device manufacture and ... ID jewelry such as Medical ID Bracelets, can rest assured that ... the new FDA requirements . ... Divoti offers this dark mark fiber laser engraving process with ...
(Date:10/11/2017)... , Oct. 11, 2017  Caris Life Sciences ... on fulfilling the promise of precision medicine, today announced ... joined Caris, Precision Oncology Alliance™ (POA) as its 17 ... centers, the St. Jude Crosson Cancer Institute will help ... the use of tumor profiling, making cancer treatment more ...
(Date:10/10/2017)... 2017  NDS received FDA 510(k) clearance in May 2017 for ... stand specifically designed for endoscopy environments. An innovative secondary monitor solution, ... solution to support the improvement of patient outcomes, procedural efficiency, and ... ... ...
Breaking Medicine Technology: