Clearing the Air Around Crohn’s Disease

In the first study to assess the association of smoking among patients with Crohn’s disease (CD) and sequencing of biologic therapies, researchers at the University of Maryland found that smoking did not appear to affect the number of biologics used.

However, they wrote in Inflammatory Bowel Disease, “smoking is a well-established risk factor for poor health outcomes, and efforts should be made to counsel patients to quit.” The authors pointed out that patients who start or continue smoking after being diagnosed with CD are at risk for poor outcomes and have higher therapeutic requirements as well as higher rates of relapse.

The investigators conducted a retrospective review of data from The Study of Prospective Adult Research Cohort with IBD (SPARC IBD) registry collected between December 2016 and January 2021 from the University of Maryland School of Medicine’s Inflammatory Bowel Disease Program. The final study cohort included 281 patients categorized into 3 exposure groups: current (n=39), former (n=70), and never smokers (n=172), The outcome of interest was the number of biologic therapies the patients received, also classified into 3 groups: 0, 1, or ≥2 biologics.

“Current, former, and never smokers had no statistically significant differences in number of biologics used (i.e., biologic sequencing),” the authors reported. “However, statistically significant independent risk factors for increased sequencing of biologics were identified. These risk factors included female sex, ileocolonic disease location, younger age at diagnosis, and prolonged disease duration; none of these factors remained significant in adjusted analyses.”

Reference:

Alizadeh M, Ali O, Cross RK. Assessing progression of biologic therapies based on smoking status in patients with Crohn’s disease. Inflamm Bowel Dis. Published July 21, 2023. https://doi.org/10.1093/ibd/izad131