Increasing smoking intensity is associated with increased disease activity in axial spondyloarthritis

Zhao, Sizheng Steven; Challoner, Benjamin; Khattak, Mohammed; Moots, Robert J.; Goodson, Nicola

doi:10.1007/s00296-016-3590-4

Cited by 24 publications

(25 citation statements)

References 19 publications

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“…Cigarette smoking has an unequivocal and strong association with onset, severity, duration, and treatment failure in several inflammatory conditions, including PsA and AS. Additionally, smoking habit has been demonstrated to correlate with disease activity in SpA [41] and has also been associated with radiographic progression in AS [41]. High BMI is strongly associated with a lower rate of achievement and maintenance of MDA.…”

Section: Discussionmentioning

confidence: 99%

One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study

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Conigliaro

et al. 2020

Expert Opinion on Biological Therapy

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Background: Secukinumab (SEC) is effective for ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in randomized trials, but real-life data are lacking. Research design and methods: Real-life, prospective observational study on 169 consecutive outpatients at baseline (T0) and at 6 (T6) and 12 months (T12) after starting SEC (39 AS, 23%; 130 PsA, 77%). Results: Significant improvement was seen at T6 and T12 for all clinical variables, including TJC, SJC, ESR, CRP, DAPSA, ASDAS-CRP, and BASDAI, as well as in patient-reported outcomes like VAS-pain. By multivariable regression analysis, in AS patients high BASDAI at T0 correlated with diagnostic delay (R 2 = 0.4; p = 0.009) and peripheral joint involvement (R 2 = 0.4; p = 0.04). During follow-up, reduction of BASDAI positively correlated with high ESR (R 2 = 0.65; p = 0.04). ASDAS-CRP at T0 positively correlated with high ESR (R 2 = 0.34; p = 0.004). Reduction of ASDAS-CRP from T0 to T6 correlated with current smoking status (R 2 = 0.42; p = 0.003). In PsA patients, reduction of DAPSA score from T0 to T12 is negatively correlated with the presence of metabolic syndrome (R 2 = 0.41; p = 0.0025). SEC was well tolerated; 10 patients discontinued treatment for non-severe adverse events. Conclusions: Secukinumab is effective and safe in patients with AS and PsA in a real-life setting.

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Section: Discussionmentioning

confidence: 99%

One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study

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Conigliaro

et al. 2020

Expert Opinion on Biological Therapy

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“…Non-smokers AS patients also achieved remission more frequently than smoker patients at the end of the study, in agreement to published data. Previous studies indicate that this factor has a dose-dependent impact on structural damage progression and in worse treatment response of SpA patients [38][39][40][41].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with ASDAS remission in a long-term study of ankylosing spondylitis patients under tumor necrosis factor inhibitors

et al. 2018

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Objective: To determine the clinical and demographic factors associated with disease remission and drug survival in patients with ankylosing spondylitis (AS) on TNF inhibitors. Methods: Data from a longitudinal electronic database of AS patients under anti-TNF therapy between June/2004 and August/2013. Demographic, clinical parameters, disease activity by ASDAS remission (< 1.3) and inactive/low (< 2.1) were analyzed to characterize reasons for drug survival and switching of anti-TNF. Results: Among 117 AS patients, 69 (59%) were prescribed only one anti-TNF, 48 (41%) switched to a second anti-TNF and 13 (11%) to a third anti-TNF. Considering ASDAS-CRP < 1.3, 31 (39%) patients were inactive at the end of the study. Non-switchers (P = 0.04), younger age (P = 0.004), non-smoking (P = 0.016), shorter disease duration (P = 0.047), more frequent use of SSZ (P = 0.037) and lower BASDAI (P = 0.027), BASMI (P = 0.034) and BASFI (P = 0.003) at baseline were associated with remission. In the multivariate analysis younger age (P = 0.016) and lower BASDAI (P = 0.032) remained as remission predictors. Conclusion: This study supports that ASDAS-CRP remission is an achievable goal not only for non-switchers but also for second anti-TNF, particularly in patients with younger age and lower BASDAI at baseline. Comedication and non-smoker status seems to have a beneficial effect in anti-TNF response in this population.

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“…Potentially modifiable environmental risk factors for increased disease activity and severity have received much research interest. There is emerging evidence that cigarette smoking is associated with a more severe disease phenotype in axSpA [ 1 , 2 ]. Some studies have also suggested that dietary modification may reduce disease activity in AS [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Alcohol and disease activity in axial spondyloarthritis: a cross-sectional study

et al. 2018

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The objective of this study was to explore associations between alcohol consumption and disease activity in axial spondyloarthritis (axSpA). We conducted a cross-sectional study of axSpA participants meeting the ASAS criteria. Associations between self-reported current alcohol use and disease activity (BASDAI, spinal pain, ASDAS), functional impairment (BASFI), and quality of life were explored using multivariable linear models, adjusting for age, gender, symptom duration, use of TNF inhibition therapy, smoking, deprivation, and anxiety and depression (A&D). Within alcohol drinkers, effect of increased alcohol intake (defined as > 14 units/week) was explored with moderate drinking (≤ 14 units/week) as reference. The study cohort comprised 229 axSpA patients and 76% were male with mean age 46.5 years (SD ± 13.8). Alcohol drinking was reported by 64%, with a median of 6 units per week among drinkers. Compared with non-drinkers, drinkers had lower BASDAI (β = − 0.83; 95% CI − 1.49, − 0.17), ASDAS (β = − 0.36; 95% CI − 0.66, − 0.05) and BASFI (β = − 1.40; 95% CI − 2.12, − 0.68). These associations were in contrast to, and independent of, the detrimental effects of smoking, depression, and deprivation. Subgroup analysis in alcohol drinkers did not reveal significant associations between disease severity and increased alcohol intake. Stratified analyses by smoking revealed that in never-smokers without depression, alcohol was associated with greater reduction in disease activity: BASDAI (β = − 1.69; 95% CI − 2.93, − 0.45), ASDAS (β = − 0.60; 95% CI − 1.18, − 0.02). Favourable axSpA disease activity and function were observed in association with alcohol consumption in this cross-sectional study. Longitudinal study is required to explore whether this relationship is due to biological effects of alcohol on disease process or disease-associated behaviour modification.

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Increasing smoking intensity is associated with increased disease activity in axial spondyloarthritis

Cited by 24 publications

References 19 publications

One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study

One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study

Factors associated with ASDAS remission in a long-term study of ankylosing spondylitis patients under tumor necrosis factor inhibitors

Alcohol and disease activity in axial spondyloarthritis: a cross-sectional study

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