Smoking Dulls Response to Medications for Back Arthritis

HealthDay News — Smoking may hamper the effects of tumor necrosis factor (TNF) inhibitors used to treat axial spondyloarthritis (axSpA), according to a study published online in the Annals of the Rheumatic Diseases.

Researchers from University Hospital Zurich looked at how 698 people with axSpA responded to treatment with TNF inhibitors. About two-thirds of the patients were smokers.

After one to two years of treatment, the drugs were significantly less effective in smokers. The difference was particularly apparent among patients who had higher levels of C-reactive protein at the start of the study. Former smokers did not experience reduced effectiveness from the drugs.

It’s not clear how smoking might impair patients’ response to these biological drugs, the researchers said in a journal news release. 

Smoking may trigger a rise in inflammation, increase pain by interfering with nerves, or starve tissues of oxygen, they suggested. 

According to the researchers, previous studies have shown that smoking increases the risk of rheumatoid arthritis and blunts the effectiveness of several arthritis drugs. They added that this is one of the first studies to examine how smoking affects treatment in people with axSpA.


1. Ciurea A. Ann Rheum D. 2015; doi:10.1136/annrheumdis-2013-205133