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Smoking linked to poor anti-TNF response

Published on 05 January 2011

Smokers with early rheumatoid arthritis appear to have a poorer response to methotrexate and anti-TNF drugs than non-smokers, a study has found.

However, ex-smokers do not appear to have a reduced response to treatment for rheumatoid arthritis.

Scientists at Sweden's Karolinska Institute analysed data on 1,430 patients, all of whom took part in a rheumatoid arthritis study between 1996 and 2006.

Of these, 873 were given methotrexate at the start of the study, while 535 started anti-TNF therapy, an effective class of biologic drugs pioneered and developed by Arthritis Research UK scientists.

Three months after starting treatment, 27 per cent of smokers had achieved a good response to methotrexate and 29 per cent had responded well to anti-TNF therapy.

These figures were lower than for non-smokers, 36 per cent of whom responded well to methotrexate and 43 per cent to anti-TNFs.

However, a history of smoking in the past did not affect patients' responses to either form of treatment.

Dr Saedis Saevarsdottir, whose findings are published in the journal Arthritis & Rheumatism, said: "Our findings provide strong evidence that clinicians should include smoking cessation programmes as part of their standard therapeutic arsenal in caring for patients with rheumatoid arthritis."

A spokesman for Arthritis Research UK said that smoking was already established as a risk factor for developing rheumatoid arthritis. "These new results are further evidence that smoking is damaging to people with rheumatoid and other forms of inflammatory arthritis, and both patients and doctors need to be very aware of this," he added.

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