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Smoking negatively affects antimalarial efficacy for treatment of cutaneous lupus erythematosus

Patients with cutaneous lupus erythematosus who smoked had a two-fold decrease in achieving cutaneous improvement from antimalarials compared with nonsmoking patients, according to recently published study results.

Researchers in Paris searched observational studies published through March 2014 in the Medline, Embase and Cochrane databases that reported on the efficacy of antimalarials, including hydroxychloroquine and chloroquine, for treating cutaneous lupus erythematosus (CLE), according to smoking status. Odds ratios were used to express association strength between smoking and cutaneous response rate.

Of the 240 citations of interest, 10 studies (four prospective, six retrospective) comprising 1,398 patients met criteria and were included in the meta-analysis.

Response to antimalarials in 797 patients with CLE who were either active smokers or ever-smokers was 0.53 (95% CI, 0.28-0.98) compared with 601 nonsmokers, according to the researchers.

“Our results further underline that the smoking status of patients with CLE should be assessed systematically and appropriate intervention offered to those who smoke, especially in the case of refractory CLE,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.