Data Suggest Smoking Doesn't Impact RA Treatment Response

No differences in mean disease activity score in 28 joints based on smoking status

THURSDAY, Dec. 20 (HealthDay News) -- For patients with early rheumatoid arthritis (RA), smoking status does not impact treatment response to early combination therapy or initial methotrexate treatment with step-up therapy, according to a study published in the December issue of Arthritis Care & Research.

Leann B. Maska, M.D., from the University of Nebraska Medical Center in Omaha, and colleagues analyzed data from 412 patients with early RA (less than three years in duration) enrolled in the Treatment of Early Aggressive Rheumatoid Arthritis study, a randomized, blinded, placebo-controlled clinical trial comparing early intensive therapy (methotrexate + etanercept or methotrexate + hydroxychloroquine + sulfasalazine triple therapy) with initial methotrexate treatment with step-up to methotrexate + etanercept or to triple therapy if the disease was still active at 24 weeks. At baseline and at 48 weeks, serum cotinine was measured as an indicator for smoking status, and the mean Disease Activity Score in 28 joints (DAS28) was compared by smoking status.

The researchers found that 71 percent of participants were categorized as nonsmokers and 29 percent as current smokers. Based on smoking status, there were no differences noted in the mean DAS28 between 48 and 102 weeks for the group (P = 0.881), or by specific treatment allocation.

"Among RA patients who smoke, effective cessation strategies remain essential for general health considerations," the authors write. "However, our data would suggest smoking cessation alone may not be an important adjunct in lessening disease activity or modifying therapeutic response to commonly used disease-remitting treatments in RA."

Two authors disclosed financial ties to pharmaceutical companies, including Amgen, which funded the study. Amgen, Barr Pharmaceuticals, and Pharmacia provided the study drugs.

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