Smoking proved not to be a predictor for response to rituximab in RA patients

A research published in the Scandinavian Journal of Rheumatology says that smoking is not an predictor of Rituximab (RTX) response among the individuals who have rheumatoid arthritis (RA). A total of 2481 RA patients (1953 non-current smokers and 528 smokers) from the CERERRA international cohort were selected and obtained the first treatment cycle and minimum one follow-up visit. The European League Against Rheumatism (EULAR), and Disease Activity Score based on 28-joint count (ΔDAS28) good response at six months were analyzed as the study outcomes with considering non-current smokers as the referent group.

At baseline the smokers were more frequently anti-citrullinated protein antibody (ACPA)/rheumatoid factor (RF) positive along with the higher number of prior biological disease-modifying anti-rheumatic drugs, lower DAS28, Health Assessment Questionnaire (HAQ) score, disease duration, and more expected to obtain simultaneous traditional synthetic disease-modifying anti-rheumatic drug (csDMARDs) than non-smokers. Further, at six months of treatment, smokers showed decreased disease activity, but the difference from the baseline DAS28  after the correction was no longer significant. Both groups exhibited similar EULAR good response rates. However, only the sero-negative smokers patients presented lower good response rates. Smoking did not predict a notable good response as HAQ, DAS28, concomitant csDMARDs, and ACPA did. Although, after stratified by country, smokers were less expected to show a good response in Sweden, and an inclination was seen in the Czech Republic.