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Smoking May Interfere With RA Treatment

Study Shows Smoking May Diminish Response to Drugs That Treat Rheumatoid Arthritis
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“The findings provide a strong impetus for clinicians to include measures against smoking as a fundamental part of their therapeutic armamentarium in RA care,” the researchers write.

“This is a very interesting study that provides further information on the impact of smoking on RA,” says David Pisetsky, MD, chief of rheumatology at Duke University Medical Center in Durham, N.C, in an email.

Exactly how smoking affects treatment response is not fully understood, he says. “Likely, it causes chronic inflammation which exacerbates the underlying problem in RA and limits response to therapy. Patients who smoke should definitely stop, but it may be particularly difficult given the stress of a chronic disease as well as potential effects of nicotine on pain perception.”

More Reasons to Quit Smoking

Previous research has shown that smoking can raise the risk for developing RA, says Theodore Fields, MD, clinical director of the Early Arthritis Initiative at the Hospital for Special Surgery in New York City. “If you are at risk for RA, such as having RA in your family, don’t smoke because it does seem to be associated with onset and some data also suggest that it worsens RA that is already there.”

“This new study suggests that if you are a smoker, you are less likely to respond well to the most commonly used drugs. So the message is, if you are at risk of RA, don't smoke -- and if you already have RA, stop smoking,” he says. “We can’t say that stopping short-term will make you respond better, but the data is suggestive. The fact that people who were still smoking did worse suggests that it’s a good idea to stop.”

This new information may help people with RA quit smoking, he says. “Smoking is bad for your lungs and for your heart, but you are less likely to respond to RA treatment, and that may be one more stimuli for a patient to stop.”

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