Can smoking and gender affect treatment response in rheumatoid arthritis patients?

This study examined whether smoking and gender can affect the response to treatment in rheumatoid arthritis patients.

The characteristics of rheumatoid arthritis (RA) differ between male and female patients. The number of affected patients, the outcome and the mortality rates differ between males and females. Males are known to respond better to treatment, while females are known to have greater functional disability.

Smoking is believed to play a role in the development of RA. It is not known whether smoking can affect the remission (no signs and symptoms of disease after treatment) rate in males and females. 

This study aimed to determine whether smoking affects remission in male and female RA patients.

This study involved 810 men and 4206 women with RA. The participants were divided into five groups. Male participants were classified as never smokers, past smokers, and current smokers. Female participants were classified as never smokers or current smokers. Participants completed a questionnaire to determine their smoking status. The disease activity was determined for each patient based on examination of the joints.

Male participants who never smoked were more likely to achieve remission in comparison to those who smoked. Male past smokers were 34% less likely to achieve remission. Male current smokers were 39% less likely to achieve remission. Smoking did not affect remission in female patients. 

This study concluded that non-smoking male RA patients are more likely to achieve remission, while smoking does not affect remission in females. 

This study did not determine whether differences in the time from quitting smoking could affect treatment response. The intensity of smoking was not taken into account. It would have been ideal to determine whether heavy-smokers and light-smokers had a difference in response to treatment.  

Consult your physician regarding the strategies available to assist in quitting smoking in order to improve treatment outcomes.