Effects of smoking on clinical treatment outcomes amongst patients with chronic inflammatory diseases initiating biologics: secondary analyses of the prospective BELIEVE cohort study.

Autor: Larsen MGR; Department of Internal Medicine, Molecular Diagnostics and Clinical Research Unit, University Hospital of Southern Denmark, Aabenraa, Denmark.; Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.; The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark., Overgaard SH; Department of Internal Medicine, Molecular Diagnostics and Clinical Research Unit, University Hospital of Southern Denmark, Aabenraa, Denmark.; Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark., Petersen SR; Department of Clinical Research, University Hospital of Southern Denmark, Odense, Denmark., Møllegaard KM; Department of Internal Medicine, Molecular Diagnostics and Clinical Research Unit, University Hospital of Southern Denmark, Aabenraa, Denmark.; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark., Munk HL; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark.; Center for Rheumatology and Spine Diseases, Copenhagen, Denmark., Nexøe AB; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.; Department of Cancer and Inflammation Research, Odense University Hospital, Odense, Denmark.; Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark., Glerup H; University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark., Guldmann T; University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark., Pedersen N; Department of Gastroenterology, Slagelse Hospital, Slagelse, Denmark., Saboori S; Department of Gastroenterology, Slagelse Hospital, Slagelse, Denmark., Dahlerup JF; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark., Hvas CL; Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark., Andersen KW; Department of Internal Medicine, Molecular Diagnostics and Clinical Research Unit, University Hospital of Southern Denmark, Aabenraa, Denmark.; Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark., Jawhara M; Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark., Haagen Nielsen O; Department of Gastroenterology, Esbjerg and Grindsted Hospital, University of Southern Denmark, Esbjerg, Denmark., Bergenheim FO; Department of Gastroenterology, Esbjerg and Grindsted Hospital, University of Southern Denmark, Esbjerg, Denmark., Brodersen JB; Department of Internal Medicine, Molecular Diagnostics and Clinical Research Unit, University Hospital of Southern Denmark, Aabenraa, Denmark.; Department of Surgery, University Hospital of Southern Denmark, Aabenraa, Denmark., Bygum A; Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.; Clinical Institute, University of Southern Denmark, Odense, Denmark., Ellingsen T; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark., Kjeldsen J; Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.; Research Unit of Medical Gastroenterology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Christensen R; Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark., Andersen V; Department of Internal Medicine, Molecular Diagnostics and Clinical Research Unit, University Hospital of Southern Denmark, Aabenraa, Denmark.; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
Jazyk: angličtina
Zdroj: Scandinavian journal of immunology [Scand J Immunol] 2024 Sep; Vol. 100 (3), pp. e13395. Date of Electronic Publication: 2024 Jul 07.
DOI: 10.1111/sji.13395
Abstrakt: 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.
(© 2024 The Author(s). Scandinavian Journal of Immunology published by John Wiley & Sons Ltd on behalf of The Scandinavian Foundation for Immunology.)
Databáze: MEDLINE
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