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Rheumatoid Arthritis Treatment Less Effective for Smokers

Smokers with early rheumatoid arthritis less responsive to TNF inhibitors and methotrexate

TUESDAY, Jan. 11 (HealthDay News) -- Patients with early rheumatoid arthritis (RA) who smoke are less likely to respond to treatment with methotrexate (MTX) and tumor necrosis factor (TNF) inhibitors, according to a study published in the January issue of Arthritis & Rheumatism.

Saedis Saevarsdottir, M.D., Ph.D., from the Karolinska University Hospital, Stockholm, Sweden, and colleagues analyzed clinical data from 1,430 patients enrolled in the Epidemiological Investigation of Rheumatoid Arthritis study between 1996 and 2006. Of the patients, 873 were treated with MTX, and 535 initiated TNF inhibitor therapy.

Investigators found that current smokers were less likely than those who had never smoked to achieve a good response according to the European League Against Rheumatism (EULAR) criteria at the 3-month visit when treated with MTX (27 percent versus 36 percent) or TNF inhibitors (29 percent versus 43 percent). Current smoking was associated with less likelihood of a good response over a 5-year follow-up period (Odds Ratio for 3 months = 0.61, 6 months = 0.65, 2 years = 0.66, and 5 years = 0.61). Past smoking history did not affect the response to treatment with MTX or TNF inhibitors.

"In conclusion, our findings indicate that cigarette smokers have a diminished chance of responding well to the currently first- and second-line agents of choice in early RA treatment today: MTX and TNF inhibitors, respectively," the authors write.

One author disclosed financial ties to Wyeth and Bristol-Myers Squibb.

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