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Smoking, rheumatoid factor status and responses to rituximab
  1. Abdul Khan1,
  2. David Lloyd Scott1,
  3. Mike Batley2
  1. 1Department of Rheumatology, King's College London School of Medicine, London, UK
  2. 2Department of Rheumatology, Maidstone and Tunbridge Well NHS Trust, London, UK
  1. Correspondence to Dr Abdul Khan, Department of Rheumatology, King's College London School of Medicine, Weston Education Centre, Denmark Hill, 10 Cutcombe Road, London, SE5 9RJ, UK; abdulkhan1{at}nhs.net

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As many active rheumatoid arthritis (RA) patients do not fully respond to biological therapies, there is growing interest in response predictors. Rheumatoid factor (RF) status predicts responses to rituximab; seropositive patients have higher response rates.1,,5 Smoking status predicts responses to tumour necrosis factor (TNF) inhibitors; non-smokers have higher response rates.6,,9

We evaluated whether smoking and autoantibody status interact in predicting responses to rituximab in active RA patients treated in routine practice settings. We used National Institute for Health and Clinical Excellence response criteria of falls in Disease Activity Scores for 28 joints (DAS28) of ≥1.2 after 6 months treatment in patients with initial DAS28 scores >5.1.

We studied 150 sequential RA patients receiving rituximab in southeast London and Kent. They comprised 109 women and 41 men, mean age …

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