Résumé
The aim of proposed study is to update the information on the impact of smoking in the response to treatment of Grave’s orbitopathy (GO), with the arrival of new therapies such as rituximab and tocilizumab, as well as the management of smoking cessation in a real life study.Materials and methods: the proposed retrospective bicentric study conducted at the University Hospitals of Nîmes and Montpellier, France. The included patients had to have GO treated by intravenous (IV) corticosteroid therapy, rituximab bolus and/or tocilizumab bolus. The primary endpoint was the comparison of the time between the completion of the first IV corticosteroid bolus and the date of the last remission achieved between the smokers and non-smokers groups. The secondary endpoint was the same analysis between the active smokers group and the quit-smokers group. The assessment of the status of the smoking was also conducted as the part of the study.Results: the median duration between the completion of the first intravenous bolus and the achievement of cure was 538 days in the non-smokers group and 420 days in the smokers group, this difference was not statistically significant (p=0.47). The same duration was 393 days in the smokers group who had been weaned for 433 days in the smokers group, this difference was not statistically significant (p=0.95).Smoking status was assessed in 78 (83.9%) of the 93 patients. Of these 78 patients, 47 (60.3%) had active smoking at the time of GO diagnosis. Of the 47 smokers, 6 (12.8%) were offered a consultation with a tobaccologist, only 2 were performed. Discussion: the results of the primary and secondary endpoints are not statistically significant due to a lack of the statistical power and a significant amount of missing data inherent to the retrospective nature of the study. However, we can observe insufficient management of smoking cessation even though it is the first-line treatment. We insist on the long duration of GO’s care.