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Smoking reduces the efficacy of belimumab in mucocutaneous lupus

Parodis, Ioannis; Gomez, Alvaro; Frodlund, Martina; Jönsen, Andreas LU ; Zickert, Agneta; Sjöwall, Christopher; Bengtsson, Anders A. LU and Gunnarsson, Iva (2018) In Expert Opinion on Biological Therapy 18(8). p.911-920
Abstract

Objectives: Recently, we demonstrated a negative impact of smoking on belimumab efficacy in patients with systemic lupus erythematosus (SLE). Here, we particularly investigated clinical effects of belimumab and a potential impact of smoking in mucocutaneous and articular SLE. Methods: We surveyed 62 SLE patients treated between 2011 and 2017. Evaluation included the mucocutaneous descriptors of SLEDAI-2K (rash, alopecia, mucosal ulcers; mcSLEDAI-2K), CLASI, the arthritis SLEDAI-2K descriptor (arSLEDAI-2K) and the 28-joint count. Results: mcSLEDAI-2K and CLASI activity decreased from baseline to month 6 and 12 (P < 0.001 for all). No worsening in CLASI damage was observed. Current or previous smokers displayed a higher probability of... (More)

Objectives: Recently, we demonstrated a negative impact of smoking on belimumab efficacy in patients with systemic lupus erythematosus (SLE). Here, we particularly investigated clinical effects of belimumab and a potential impact of smoking in mucocutaneous and articular SLE. Methods: We surveyed 62 SLE patients treated between 2011 and 2017. Evaluation included the mucocutaneous descriptors of SLEDAI-2K (rash, alopecia, mucosal ulcers; mcSLEDAI-2K), CLASI, the arthritis SLEDAI-2K descriptor (arSLEDAI-2K) and the 28-joint count. Results: mcSLEDAI-2K and CLASI activity decreased from baseline to month 6 and 12 (P < 0.001 for all). No worsening in CLASI damage was observed. Current or previous smokers displayed a higher probability of unchanged/worsened mcSLEDAI-2K compared to never smokers (OR: 6.4; 95% CI: 1.5–27.4; P = 0.012), also after adjustment for antimalarial agents. arSLEDAI-2K scores had decreased at month 6 (P < 0.001) and 12 (P < 0.001). Likewise, tender and swollen 28-joint counts had improved at month 6 (P = 0.010 and P < 0.001, respectively) and 12 (P = 0.001 for both). We observed no impact of smoking on belimumab efficacy in articular SLE. Conclusion: We observed a negative impact of smoking on the efficacy of belimumab in mucocutaneous SLE. In contrast, no impact of smoking on belimumab efficacy was seen in patients with articular manifestations.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Belimumab, biological agents, drug efficacy, rheumatology, systemic lupus erythematosus
in
Expert Opinion on Biological Therapy
volume
18
issue
8
pages
911 - 920
publisher
Ashley Publications
external identifiers
  • scopus:85049639213
ISSN
1471-2598
DOI
10.1080/14712598.2018.1494719
language
English
LU publication?
yes
id
248733f2-41bf-4f37-8028-57376112ea61
date added to LUP
2018-07-20 10:47:26
date last changed
2019-01-09 16:56:37
@article{248733f2-41bf-4f37-8028-57376112ea61,
  abstract     = {<p>Objectives: Recently, we demonstrated a negative impact of smoking on belimumab efficacy in patients with systemic lupus erythematosus (SLE). Here, we particularly investigated clinical effects of belimumab and a potential impact of smoking in mucocutaneous and articular SLE. Methods: We surveyed 62 SLE patients treated between 2011 and 2017. Evaluation included the mucocutaneous descriptors of SLEDAI-2K (rash, alopecia, mucosal ulcers; mcSLEDAI-2K), CLASI, the arthritis SLEDAI-2K descriptor (arSLEDAI-2K) and the 28-joint count. Results: mcSLEDAI-2K and CLASI activity decreased from baseline to month 6 and 12 (P &lt; 0.001 for all). No worsening in CLASI damage was observed. Current or previous smokers displayed a higher probability of unchanged/worsened mcSLEDAI-2K compared to never smokers (OR: 6.4; 95% CI: 1.5–27.4; P = 0.012), also after adjustment for antimalarial agents. arSLEDAI-2K scores had decreased at month 6 (P &lt; 0.001) and 12 (P &lt; 0.001). Likewise, tender and swollen 28-joint counts had improved at month 6 (P = 0.010 and P &lt; 0.001, respectively) and 12 (P = 0.001 for both). We observed no impact of smoking on belimumab efficacy in articular SLE. Conclusion: We observed a negative impact of smoking on the efficacy of belimumab in mucocutaneous SLE. In contrast, no impact of smoking on belimumab efficacy was seen in patients with articular manifestations.</p>},
  author       = {Parodis, Ioannis and Gomez, Alvaro and Frodlund, Martina and Jönsen, Andreas and Zickert, Agneta and Sjöwall, Christopher and Bengtsson, Anders A. and Gunnarsson, Iva},
  issn         = {1471-2598},
  keyword      = {Belimumab,biological agents,drug efficacy,rheumatology,systemic lupus erythematosus},
  language     = {eng},
  month        = {08},
  number       = {8},
  pages        = {911--920},
  publisher    = {Ashley Publications},
  series       = {Expert Opinion on Biological Therapy},
  title        = {Smoking reduces the efficacy of belimumab in mucocutaneous lupus},
  url          = {http://dx.doi.org/10.1080/14712598.2018.1494719},
  volume       = {18},
  year         = {2018},
}