title: Effect of Smoking on Remission Proportions Differs Between Male and Female Patients with Rheumatoid Arthritis: A Study Based on the IORRA Survey.
abstract: OBJECTIVE
  To analyze sex difference in the effect of smoking on remission proportions in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Subjects were Japanese patients with RA who participated in the IORRA survey conducted in April 2011 and reported smoking status. Clinical characteristics, treatment status, and the percentages achieving remission were compared between subjects stratified by sex and smoking status. To confirm the differential effects of sex and smoking status on remission, we used multivariate logistic regression models with the dependent variable as 28-joint Disease Activity Score (DAS28) remission.
  
  
  RESULTS
  Among 810 men and 4206 women, 162 (20.0%) and 3173 (75.4%), respectively, were never smokers; 208 (25.7%) and 314 (7.5%), respectively, were current smokers. In men, never smokers tended to have higher remission proportions than past and current smokers. In contrast, smoking status seemed not to affect remission in women. Except for lower corticosteroid dose in male never smokers, no significant differences were observed in comparing treatment status. By multivariate analyses, male past and current smokers were negatively associated with DAS28-erythrocyte sedimentation rate remission compared to male never smokers [OR 0.66 and 0.61, 95% CI (0.44-0.98) and (0.39-0.96), respectively]. However, female past and current smokers were not associated with remission compared to female never smokers [OR 1.04 and 1.19, 95% CI (0.86-1.25) and (0.91-1.54), respectively].
  
  
  CONCLUSIONS
  We demonstrated that the effect of smoking on remission proportions differed between men and women. Our findings suggest that both sex and smoking status are important considerations when planning a treatment strategy for patients with RA.
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University. ayakonkj@ior.twmu.ac.jp.
authors.forename: Ayako
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Inoue
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kobayashi
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hoshi
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sugimoto
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Seto
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Taniguchi
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Fukuoka Red Cross Hospital, Fukuoka, Japan.Y. Inoue, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University (present address, Fukuoka Red Cross Hospital); A. Nakajima, MD, PhD, Associate Professor; E. Tanaka, MD, PhD; E. Inoue, PhD; A. Kobayashi, MD; D. Hoshi, MD; N. Sugimoto, MD; Y. Seto, MD, PhD; A. Taniguchi, MD, PhD, Professor; S. Momohara, MD, PhD, Professor; H. Yamanaka, MD, PhD, Professor and Director, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents
keywords: DISEASE ACTIVITY; REMISSION; RHEUMATOID ARTHRITIS; SEX DIFFERENCES; SMOKING