Session Information
Date: Monday, November 6, 2017
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose:
Biologiccs (Bio) have shown outstanding efficacy and became one of the most effective drugs in the treatment of RA. However, several issues remain, including adverse effect (AE), therapeutic failure (Failure), and expensiveness. On the other hand, cumulative evidence has suggested that some genetic and environmental factors affects responsivenesss of anti-rheumatic drugs including Bio. Smoking is thought to be one of crucial environmental factors. The purpose of this study is to investigate the influence of smoking on Bio treatment in RA.
Methods: The association between smoking habit and discontinuation of Bio treatment was analyzed on Japanese RA patient cohort (11940 patients). Smoking habit was assessed by questionnaire and the patients were divided into three groups as current smoker, never smoker, ever smoker. The total percentages of discontinuation were analyzed according to four categories: Failure, adverse effect (AE), Remission, and others. The association between the causes of discontinuation of Bio and smoking habit was analyzed statistically.
Results: 3,187 (26.7%) of the total registered patients were treated with one or more Bio during 6 years. Among them, 584, 1,321, 397, 589, 223, and 73 patients were treated with IFX, ETN, ADA, TCZ, ABT and GLM respectively. Failure in the current smoker group was significantly more frequent than never smoker and ever smoker groups (OR=0.678, 95%CI:0.482~0.967, OR=0.577, 95%CI:0.357~0.869, respectively). Among therapeutic targets, patients treated with TNF inhibitors (IFX, ETN, ADA, GLM) showed more significant association between smoking habit and Failure than those treated with either IL-6 inhibitor (TCZ) or T cell inhibitor (ABT).
Conclusion: Smoking reduced responsiveness of treatment by Bio in RA, especially when treated with TNF inhibitors. Smoking cessation may reduce failure of treatment by Bio in RA.
To cite this abstract in AMA style:
Kuzuya K, Saeki Y, Hashimoto J, Oshima S, Matsushita M, Tuji S, Harada Y, Yoshimura M, Teshigawara S, Matsuoka H. Smoking Reduces Efficacy of Biologics Differently By Target Cytokines in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/smoking-reduces-efficacy-of-biologics-differently-by-target-cytokines-in-rheumatoid-arthritis/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/smoking-reduces-efficacy-of-biologics-differently-by-target-cytokines-in-rheumatoid-arthritis/