Objective: Observational data facilitate examination of treatment-effect heterogeneity, but the risk of bias is substantial. The present study was undertaken to highlight methodologic considerations through an analysis of whether smoking affects response to tumor necrosis factor inhibitors (TNFi) in axial spondyloarthritis (SpA).
Methods: We used longitudinal data from the British Society for Rheumatology Biologics Register for Ankylosing Spondylitis. Participants fulfilling the Assessment of SpondyloArthritis international Society criteria for axial SpA who started their first TNFi were eligible for analysis. In comparing the impact of smoking status, weighted generalized estimating equations were used to examine changes in several continuous outcome measures, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS). Inverse probability weights were used to account for differences in baseline covariates and excluded participants. We separately assessed response in the first 3 months to account for nonrandom dropout.
Results: For 840 participants who started on TNFi, 1,641 assessments from 627 individuals were analyzed (69% male, mean age 46 years). A total of 33% were current smokers and 30% ex-smokers. Ex-smokers and current smokers had worse disease than never smokers at baseline. Accounting for these differences, response did not differ according to smoking status. Compared to never smokers, ex-smokers (β = -0.6, 95% confidence interval [95% CI] -1.4, 0.3) and current smokers (β = -0.4, 95% CI -1.1, 0.4) had a similar response according to the BASDAI and ASDAS (ex-smokers β = -0.1, 95% CI -0.5, 0.3; current smokers β = -0.01, 95% CI -0.4, 0.4) at 3 months.
Conclusion: TNFi response did not differ according to baseline smoking status in this UK cohort. Conflicting results from previous studies were likely due to methodologic differences. This analysis highlights potential sources of bias that should be addressed in future studies.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694004 | PMC |
| http://dx.doi.org/10.1002/acr.23851 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Basic Science and Pathogenesis.
Alzheimers Dement
December 2024
Boston University Alzheimer's Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Background: Alzheimer's disease (AD) has both genetic and environmental risk factors. Gene-environment interaction may help explain some missing heritability. There is strong evidence for cigarette smoking as a risk factor for AD.
View Article and Find Full Text PDFPrevalence of infertility and the effect of covariates on survival time to pregnancy: A nationally representative population based cross sectional study.
Int J Gynaecol Obstet
January 2025
Population Services International, Addis Ababa, Ethiopia.
Objective: This study sought to estimate population level prevalence of infertility and explored whether time to pregnancy is related to selected factors.
Methods: This study's analysis was based on data collected from 2081 women who were sampled from participants of the 2016 Ethiopia Demographic and Health Survey based on risk of pregnancy criteria: age between 15 and 49 years, currently married or cohabitating, sexually active, not used contraception method during the 5 years before interview, not menopausal, and not pregnant. We used a current duration (CD) approach in which for each woman we calculated the length of time-at-risk of pregnancy (CD value) in months.
Factor associated with and risk of cardiovascular disease in people with uncontrolled hypertension.
Sci Rep
January 2025
Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
We aimed to identify and validate factors related to uncontrolled hypertension. Participants treated with at least one antihypertensive drug from the prospective contemporaneous CoLaus|PsyCoLaus study were enrolled. We investigated the association between hypertension status (uncontrolled, defined as systolic blood pressure [SBP] ≥ 140 mm Hg and/or diastolic blood pressure [DBP] ≥ 90 mm Hg, versus controlled hypertension [SBP/DBP < 140/90 mm Hg]) and potential risk factors.
View Article and Find Full Text PDFSmoking Experience before Adulthood Is Associated with an Increased Risk of Developing Ulcerative Colitis in Adult Ex-Smokers.
Yonsei Med J
January 2025
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Purpose: Smoking may have a protective role in developing ulcerative colitis (UC) but have the opposite effect on Crohn's disease (CD). This study aimed to determine the risk of developing inflammatory bowel disease (IBD) according to smoking status and onset age of smoking.
Materials And Methods: We collected data on the smoking experiences of participants aged 20-39 years who underwent biannual examinations provided by the Korean National Health Screening Program from 2009 to 2012.
Non-invasive screening for laryngeal cancer using the oral cavity as a proxy for differentiation of laryngeal cancer versus leukoplakia: A novel application of ESS technology and artificial intelligence supported statistical modeling.
Am J Otolaryngol
December 2024
Boston University Chobanian and Avedisian School of Medicine, 72 E. Concord Street, Boston, MA 02118, USA; Department of Otolaryngology, Boston Medical Center, 800 Harrison Avenue, Boston, MA 02118, USA. Electronic address:
Objective: This preliminary study tested whether non-invasive, remote Elastic Scattering Spectroscopy (ESS) measurements obtained in the oral cavity can be used as a proxy to accurately differentiate between patients with laryngeal cancer versus laryngeal leukoplakia.
Methods: 20 patients with laryngeal lesions [cancer (n = 10),leukoplakia (n = 10)] were clinically assessed and categorized by otolaryngologists per standard clinical practice. Patient demographics of age, race, sex, and smoking history were collected.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!