Impact of tobacco smoking on response to tumor necrosis factor-alpha inhibitor treatment in a sample of Iraqi patients with ankylosing spondylitis

Abstract

Background: Tobacco smoking has a great burden on human health status and is the cause of many morbidities and a high death rate. Smoking is involved in the etiology and deterioration of ankylosing spondylitis. Aim of the study: To assess the effect of smoking in affecting response to tumor necrosis factor-alpha inhibitor treatment in ankylosing spondylitis patients. Patients and Methods: A retrospective cross-sectional study was conducted at the Rheumatology Unit of Baghdad Teaching Hospital/Medical Complex in Baghdad City-Iraq for a duration of six months from 1st December 2021 to 31st May 2022 on a sample of 150 Iraqi patients with ankylosing spondylitis. Ankylosing spondylitis patients has been diagnosed based on the modified New York criteria and tumor necrosis factor-alpha inhibitor prescribed for them. The smoking status, ESR, BASDAI, and BASFI of patients were assessed by the researcher. Results: Non-smoking was observed in 46.7% of ankylosing spondylitis patients, while current smoking was observed in 46.7% of patients and ex-smoking in 6.6% of them. The mean ESR level after 6 months of treatment was significantly higher among ankylosing spondylitis patients with current smoking (P=0.002). The mean BASDAI score after 6 months of treatment was significantly higher among ankylosing spondylitis patients with ex-smoking (p