Current smoking negatively affects the response to methotrexate in RA in a dose-responsive way, independently of concomitant prednisone use

2021 ◽  
pp. jrheum.200213
Author(s):  
Mary Safy-Khan ◽  
Maria J.H. de Hair ◽  
Paco M.J. Welsing ◽  
Jacob M. van Laar ◽  
Johannes W.G. Jacobs
Keyword(s):  
Clinical Response ◽  
Disease Activity Score ◽  
Smoking Status ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Negative Effect ◽  
Mixed Modelling ◽  
The Impact ◽  
Dose Dependent ◽  
Relevant Covariates

Objective Current smoking reduces clinical response to several disease-modifying antirheumatic drugs (DMARDs). It is unknown if this is also the case for prednisone. We aimed to determine whether current smoking affects the clinical response to concomitant prednisone in a methotrexate (MTX)-based treatment strategy. Methods In the CAMERA-II trial, early rheumatoid arthritis (RA) patients initiated an MTX-based strategy and were randomized to concomitant prednisone (MTX+pred) or placebo (MTX+plac) for 24 months. Linear mixed modelling was performed with disease activity score assessing 28 joints (DAS28) as dependent variable and strategy group and current smoking status as independent variables, correcting for relevant covariates. The interaction between current smoking and strategy was tested to find out whether the impact of current smoking on clinical response was different between the strategy groups with prednisone or placebo. Results Current smoking was significantly associated with higher DAS28 over time (mean difference with non-smokers 0.57 (95% confidence interval 0.22 to 0.92), p<0.01). This association was not different between the strategy groups with prednisone or placebo (p=0.73). This negative effect of current smoking on DAS28 was dose dependent. Conclusion Current smoking in early RA patients significantly reduces the clinical effect of an MTX-based strategy, independent of whether concomitant prednisone is used or not. This effect is dose dependent.

scholarly journals Smoking and Methotrexate Inefficacy in Rheumatoid Arthritis: What About Underlying Molecular Mechanisms?

2021 ◽  
pp. jrheum.210217
Author(s):  
Gerrit Jansen ◽  
Maurits C.F.J. de Rotte ◽  
Robert de Jonge
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Molecular Mechanisms ◽  
Disease Activity Score ◽  
Current Issue ◽  
Early Arthritis ◽  
Current Smoking ◽  
Negative Effect ◽  
Dose Dependent ◽  
Over Time

The study by Safy-Khan, et al in the current issue of The Journal of Rheumatology1 reports that in a methotrexate (MTX)-based treatment regimen for patients with early arthritis, current smoking was significantly associated with a smaller reduction of Disease Activity Score in 28 joints (DAS28) over time compared to noncurrent smoking. This negative effect of current smoking on DAS28 was dose-dependent: patients who smoked 10–19 cigarettes per day did worse than patients who smoked 1–9 cigarettes per day.

Risk Factors for Olfactory and Gustatory Dysfunctions in Patients with SARS-CoV-2 Infection

2021 ◽  
pp. 1-8
Author(s):  
Francesca Galluzzi ◽  
Veronica Rossi ◽  
Cristina Bosetti ◽  
Werner Garavello
Keyword(s):  
Risk Factors ◽  
Smoking Status ◽  
Inverse Association ◽  
Current Smoking ◽  
Logistic Regression Models ◽  
Respiratory Allergies ◽  
History Of ◽  
Never Smokers ◽  
Smell Loss ◽  
Relevant Covariates

<b><i>Introduction:</i></b> Smell and taste loss are characteristic symptoms of SARS-CoV-2 infection. The aim of this study is to investigate the prevalence and risk factors associated with olfactory and gustatory dysfunctions in coronavirus disease (COVID-19) patients. <b><i>Methods:</i></b> We conducted an observational, retrospective study on 376 patients with documented SARS-CoV-2 infection admitted to the San Gerardo Hospital in Monza, Italy, from March to July 2020. All patients answered a phone questionnaire providing information on age, sex, smoking status, and clinical characteristics. Adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated through logistic regression models including relevant covariates. <b><i>Results:</i></b> The prevalence of olfactory and gustatory dysfunctions in COVID-19 patients was 33.5 and 35.6%, respectively. Olfactory dysfunctions were significantly directly associated with current smoking and history of allergy, the multivariable ORs being 6.53 (95% CI 1.16–36.86) for current smokers versus never smokers, and 1.89 (95% CI 1.05–3.39) for those with an allergy compared to those without any allergy. Respiratory allergy in particular was significantly associated with olfactory dysfunctions (multivariable OR 2.30, 95% CI 1.02–5.17). Significant inverse associations were observed for patients aged 60 years or more (multivariable OR 0.33, 95% CI 0.19–0.57) and hospitalization (multivariable OR 0.22, 95% CI 0.06–0.89). Considering gustatory dysfunctions, after allowance of other variables a significant direct association was found for respiratory allergies (OR 2.24, 95% CI 1.03–4.86), and an inverse association was found only for hospitalization (OR 0.21, 95% CI 0.06–0.76). <b><i>Conclusion:</i></b> Our study indicates that current smoking and history of allergy (particularly respiratory) significantly increase the risk for smell loss in COVID-19 patients; the latter is also significantly associated to taste loss. Hospitalization has an inverse association with the risk of olfactory and gustatory dysfunctions, suggesting that these may be symptoms characteristics of less severe SARS-CoV-2 infection.

An observational study to determine the prevalence of alcohol use disorders in advanced cancer patients

2011 ◽  
Vol 26 (4) ◽  
pp. 360-367 ◽  
Author(s):  
Katherine Webber ◽  
Andrew N Davies
Keyword(s):  
Alcohol Use ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Alcohol Use Disorder ◽  
Smoking Status ◽  
Alcohol Use Disorders ◽  
Symptom Burden ◽  
Advanced Cancer Patients ◽  
Current Smoking Status ◽  
Current Smoking

Context: observational studies in North America suggest alcohol dependence is a common problem in advanced cancer patients and is associated with a high burden of physical and psychological symptoms. The prevalence of all types of alcohol use disorders, and the relationship between alcohol use disorders and symptoms, has not been studied. Objectives: this observational, cross-sectional study was designed to determine the prevalence of alcohol use disorders in patients with advanced cancer and establish if such patients have a higher symptom burden. Methods: sequential patients referred to the palliative medicine team at a United Kingdom cancer centre completed the Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale (HADS) and Memorial Symptom Assessment Scale-Short Form (MSAS-SF). Results: 120 patients participated in the study. Twenty-two (18%) patients screened positively for the presence of an alcohol use disorder. This study found no significant association between alcohol use disorders and the presence of anxiety ( P = 0.38) or depression ( P = 0.81) on the HADS or the global distress index subscale ( P = 0.142), physical symptom distress index subscale ( P = 0.734), or the psychological distress index subscale ( P = 0.154) on the MSAS-SF. Current smoking status was the only independent predictor for the presence of an alcohol use disorder ( P < 0.001). Seven (6%) patients screened positively for high-risk alcohol use disorders. Current smoking status ( P < 0.001) and male gender ( p < 0.001) were independent predictors of this problem. Conclusions: alcohol use disorders in this cohort of patients were not associated with a higher symptom burden, and the prevalence was lower than the general United Kingdom population.

Contemplating to quit current smoking status: differences in behavioural and psychosocial patterns in a population-based cohort of current smokers

2005 ◽  
Vol 41 (1) ◽  
pp. 134-140 ◽  
Author(s):  
Karl-Heinz Ladwig ◽  
Jens Baumert ◽  
Hannelore Löwel ◽  
Angela Döring ◽  
Heinz-Erich Wichmann
Keyword(s):  
Smoking Status ◽  
Population Based ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Status Differences

scholarly journals Depression and substance abuse and dependency in relation to current smoking status and frequency of smoking among nondaily and daily smokers

2013 ◽  
Vol 22 (6) ◽  
pp. 581-589 ◽  
Author(s):  
Carla J. Berg ◽  
Hefei Wen ◽  
Janet R. Cummings ◽  
Jasjit S. Ahluwalia ◽  
Benjamin G. Druss
Keyword(s):  
Substance Abuse ◽  
Smoking Status ◽  
Current Smoking Status ◽  
Current Smoking

scholarly journals Associations between pain and current smoking status among cancer patients

Pain ◽  
2011 ◽  
Vol 152 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Joseph W. Ditre ◽  
Brian D. Gonzalez ◽  
Vani N. Simmons ◽  
Leigh Anne Faul ◽  
Thomas H. Brandon ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Smoking Status ◽  
Current Smoking Status ◽  
Current Smoking

scholarly journals Changes in DNA methylation from pre- to post-adolescence are associated with pubertal exposures

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Luhang Han ◽  
Hongmei Zhang ◽  
Akhilesh Kaushal ◽  
Faisal I. Rezwan ◽  
Latha Kadalayil ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Pathway Analysis ◽  
Smoking Status ◽  
Growth Spurt ◽  
Related Factors ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Epigenetic State ◽  
Immune System Development ◽  
Gender Specific

Abstract Background Adolescence is a period characterized by major biological development, which may be associated with changes in DNA methylation (DNA-M). However, it is unknown to what extent DNA-M varies from pre- to post-adolescence, whether the pattern of changes is different between females and males, and how adolescence-related factors are associated with changes in DNA-M. Methods Genome-scale DNA-M at ages 10 and 18 years in whole blood of 325 subjects (n = 140 females) in the Isle of Wight (IOW) birth cohort was analyzed using Illumina Infinium arrays (450K and EPIC). Linear mixed models were used to examine DNA-M changes between pre- and post-adolescence and whether the changes were gender-specific. Adolescence-related factors and environmental exposure factors were assessed on their association with DNA-M changes. Replication of findings was attempted in the comparable Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Results In the IOW cohort, after controlling for technical variation and cell compositions at both pre- and post-adolescence, 15,532 cytosine–phosphate–guanine (CpG) sites (of 400,825 CpGs, 3.88%) showed statistically significant DNA-M changes from pre-adolescence to post-adolescence invariant to gender (false discovery rate (FDR) = 0.05). Of these 15,532 CpGs, 10,212 CpGs (66%) were replicated in the ALSPAC cohort. Pathway analysis using Ingenuity Pathway Analysis (IPA) identified significant biological pathways related to growth and development of the reproductive system, emphasizing the importance of this period of transition on epigenetic state of genes. In addition, in IOW, we identified 1179 CpGs with gender-specific DNA-M changes. In the IOW cohort, body mass index (BMI) at age 10 years, age of growth spurt, nonsteroidal drugs use, and current smoking status showed statistically significant associations with DNA-M changes at 15 CpGs on 14 genes such as the AHRR gene. For BMI at age 10 years, the association was gender-specific. Findings on current smoking status were replicated in the ALSPAC cohort. Conclusion Adolescent transition is associated with changes in DNA-M at more than 15K CpGs. Identified pathways emphasize the importance of this period of transition on epigenetic state of genes relevant to cell growth and immune system development.

scholarly journals Treatable traits qualifying for nonpharmacological interventions in COPD patients upon first referral to a pulmonologist: the COPD sTRAITosphere

2020 ◽  
Vol 6 (4) ◽  
pp. 00438-2020
Author(s):  
Alex J. van ’t Hul ◽  
Eleonore H. Koolen ◽  
Jeanine C. Antons ◽  
Marianne de Man ◽  
Remco S. Djamin ◽  
...  
Keyword(s):  
Health Status ◽  
Depressed Mood ◽  
Smoking Status ◽  
Self Management ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Copd Patients ◽  
Severe Fatigue ◽  
Poor Nutritional Status ◽  
Impaired Health

IntroductionThe present study assessed the prevalence of nine treatable traits (TTs) pinpointing nonpharmacological interventions in patients with COPD upon first referral to a pulmonologist, how these TTs co-occurred and whether and to what extent the TTs increased the odds having a severely impaired health status.MethodsData were collected from a sample of 402 COPD patients. A second sample of 381 patients with COPD was used for validation. Nine TTs were assessed: current smoking status, activity-related dyspnoea, frequent exacerbations <12 months, severe fatigue, depressed mood, poor physical capacity, low physical activity, poor nutritional status and a low level of self-management activation. For each TT the odds ratio (OR) of having a severe health status impairment was calculated. Furthermore, a graphic representation was created, the COPD sTRAITosphere, to visualise TTs prevalence and OR.ResultsOn average 3.9±2.0 TTs per patient were observed. These TTs occurred relatively independently of each other and coexisted in 151 unique combinations. A significant positive correlation was found between the number of TTs and Clinical COPD Questionnaire total score (r=0.58; p<0.001). Patients with severe fatigue (OR: 8.8), severe activity-related dyspnoea (OR: 5.8) or depressed mood (OR: 4.2) had the highest likelihood of having a severely impaired health status. The validation sample corroborated these findings.ConclusionsUpon first referral to a pulmonologist, COPD patients show multiple TTs indicating them to several nonpharmacological interventions. These TTs coexist in many different combinations, are relatively independent and increase the likelihood of having a severely impaired health status.

scholarly journals Does Current General Mental Health Status Relate to Current Smoking Status in Pregnant Women?

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Diane Liu ◽  
Emily Younger ◽  
Stacy Baker ◽  
Stephanie Touch ◽  
Tamara Willmoth ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Status ◽  
Pregnant Women ◽  
Tobacco Use ◽  
Smoking Status ◽  
Mental Health Status ◽  
Current Smoking Status ◽  
Current Smoking ◽  
General Mental Health ◽  
Current Tobacco

Purpose. Research shows that smoking during pregnancy is related to mental health diagnoses. The purpose of this study was to assess whether current general mental health status is related to current smoking status in pregnant women after controlling for other factors related to both mental health and tobacco use during pregnancy. Methods. This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance Survey (BRFSS) data for 621 pregnant women aged 18-38 from Florida (N=136), Kansas (N=116), Minnesota (N=105), Nebraska (N=90), New York (N=78), and Utah (N=96). Multiple logistic regression analysis was used to assess the relationship between current mental health status and current tobacco use, while controlling for state, depression diagnosis, routine checkup, healthcare plan, age, marital status, ethnicity/race, education level, income level, and employment status. Results. Overall, very few participants reported current smoking (6%) and about one-third reported low or moderate mental health status in the past 30 days. Adjusted results indicated that those who reported high mental health status were about 3 times less likely (OR=0.29, 95% CI=0.09, 0.88) to report current smoking status compared to those who reported low mental health status. Conclusions. Overall, current mental health status was highly related to current smoking status in pregnant women. Clinicians in obstetrics may expect a very low proportion of pregnant women to report smoking and up to one-third to report low or moderate current general mental health status. Given that current mental health issues and current tobacco use may harm both mother and child, be highly related in pregnant women, and change throughout the pregnancy, pregnant women should be screened automatically for both at each visit.

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