The impact of smoking on response to tumor necrosis factor-α inhibitor treatment in patients with ankylosing spondylitis

Background/aim: To investigate the impact of smoking on disease activity, treatment retention, and response in patients with ankylosing spondylitis (AS) treated their first tumor necrosis factor-α inhibitor (TNFi). Materials methods: AS who started TNFi for active axial (BASDAI ≥ 4) from TURKBIO Registry were included. Treatment smoker (current ex-smokers) nonsmoker (never smoker) primarily evaluated as achievement BASDAI50 or improvement BASDAI at least 20 mm 3 months 6 compared to baseline. Results: There 322 (60% male, 59% smoker, mean age: 38.3 years). The median follow-up time was 2.8 years (Q1- Q3: 1.3-3.8), duration 3.5 (Q1-Q3: 0.7-8.2). Smokers had male predominance (p < 0.001), lower ESR = 0.03), higher 0.02), BASFI 0.05), HAQ-AS 0.007), ASDAS-CRP 0.04) nonsmokers In multivariate analysis, gender [OR 2.7 (95%CI 1.4-5), p 0.002], concomitant conventional synthetic disease-modifying antirheumatic drug use 2.4 1.1-5.2), 0.03] associated better response. an association [HR 1.6-3.7), 0.001], older age (≥ 30years) 1.8 1.1-2.8), 0.01], 1.2-2.9), 0.008] retention. No status found retention univariate analyses. Conclusion: This study suggested that poorer patient-reported outcomes biologic naïve initiating treatment, but it no rate.