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  1. Home
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Browsing by Author "Yazici, A"

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    Effect of Carbonitriding on Corrosion Resistance of Steel 30MnB5 in Two Acidic Environments
    Yazici, A; Zeybek, MS; Güler, H; Koç, M; Pekytkan, FG
    Corrosion resistance of steel 30MnB5 is studied after carbonitriding, after conventional quenching, and without treatment. Corrosion tests are performed for from 24 to 168 h in two acidic environments (in a hydrochloric acid solution with 10% mole fraction and in fertilizer-containing soil). It is shown that the rate of corrosion of the steel in both environments after carbonitriding is lower than after quenching).
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    Corrosion resistance and mechanical properties of quenched and tempered 28MnCrB5 steel in two acidic environments
    Yazici, A; Zeybek, MS; Güler, H; Pinar, AM; Tücer, R
    Microstructure, hardness distribution, tensile properties and fracture behavior of the quenched and tempered steel 28MnCrB5 were investigated before and after corrosion tests. The corrosion behavior of the quenched and tempered steel 28MnCrB5 was examined in two different acidic environments, namely a hydrochloric acid solution and fertilizer-containing soil. The specimens were immersed in corrosive environments for 24, 48, 72, 96, 120, 144 and 168 hours, and additionally into fertilizer-containing soil for 240 days. The corrosion losses were determined by measuring the weight changes and the respective corrosion rates were calculated. Ductile fracture was observed in the sample of the quenched and tempered material before and after 168 hours of exposure to the hydrochloric acid solution and fertilizer-containing soil environment. But, in the sample subjected to corrosion in the fertilizer-containing soil environment for 240 days, brittle fracture took place and the fracture topography on the surface exhibited inter-granular cleavage. After 240 days of corrosion test in the fertilizer-containing soil environment, the ductility of the material decreased to a very great extent. The surface of the quenched and tempered 28MnCrB5 samples was covered by corrosion pits, cracks and peelings at the end of 168 h tests in the hydrochloric acid solution environment. At the end of 240 day tests in the fertilizer-containing soil environment, the surface of the samples showed deep peelings and cracks.
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    Effect of different corrosive media on the corrosion resistance and mechanical properties of armor steel
    Yazici, A; Zeybek, MS; Kahraman, F
    Armor steel samples were exposed to corrosion for 24, 72, 168, and 720 h in two different corrosive media. The corrosion rate was determined using mass loss, measurement of the concentration of components in the corrosive medium solution, and Tafel extrapolation methods. Before and after corrosion experiments, the tensile properties, surface characteristics, and phase structures of the samples were examined. The surface analyses were performed using the SEM technique combined with EDX analyses, and the phase analyses were performed by X-ray diffraction. The corrosion rate determined by the mass loss method was 0.02 +/- 0.01 mm year(-1) for the 3.5wt% NaCl medium and 2.66 +/- 0.16 mm year(-1) for the 1 MHCl medium. The corrosion rate values determined by the Tafel extrapolation method were 0.02 +/- 0.01 mm year(-1) in the 3.5 wt% NaCl medium and 1.21 +/- 0.01 mm year(-1) in the 1 M HCl medium. There was a decrease in the tensile, yield strengths, and elongation to fracture values of the corroded samples compared to the non-corroded samples. While intergranular ductile fracture occurred in samples exposed to 3.5wt% NaCl medium, there were features reminiscent of the brittle fracture in samples exposed to the 1 M HCl/168 h medium.
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    INVESTIGATION OF THE WEAR BEHAVIOR OF MARTEMPERED 30 MnB5 STEEL FOR SOIL TILLAGE
    Yazici, A
    The objective of this experimental study was to determine the wear resistance of moldboard plowshares produced from 30 MnB5 steel that were treated with different martempering conditions. The microstructures, the hardness distributions, and the wear behavior of the martempered 30 MnB5 steel were determined and compared with conventionally heat-treated samples in laboratory conditions. The wear losses of all martempered samples were less than that of the conventionally heat-treated samples in laboratory conditions, especially at the end of a longer-term wear experiment. The martempering process in which the steel was austenized at 960 degrees C for 35 min, held at 350 degrees C for 10 s in a salt bath, and then cooled in air produced the best results for decreasing wear loss in laboratory conditions. The martempering treatment that resulted in the lowest wear weight loss in pin-on-disc tests was selected for further testing in field conditions. The field used for the experiment was flat and free of crop residue with a uniformly dispersed soil type (sandy and sandy loam). A reversible plow was used to measure the wear The abrasive wear losses were determined by measuring the plowshare's weight and dimensions before and after tillage. By achieving a more uniform hardness distribution, the lath-type martensitic and bainitic microstructure of the martempered plowshares significantly increased their wear resistance. The martempering process decreased the wear weight loss by 40.8% and the wear dimension loss by 38.5% compared to conventionally heat-treated plowshares in field conditions.
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    Wear on steel tillage tools: A review of material, soil and dynamic conditions
    Yazici, A
    The tribological process between the tillage tools and the soil is quite complex. Wear on tillage tools changes depending on the material of the tool, opposing material (soil), environment (moisture, temperature), and dynamic factors (stress on sliding surface, sliding time, sliding speed, and sliding type). Chemical composition, microstructure, and mechanical properties of the material from which the tools are made; soil properties such as texture, structure, density, moisture, rock and gravel content; operating conditions such as tillage speed and depth; geometry and surface roughness of the tool, and impact angle with the soil are effective on wear. It is generally accepted that tillage tools go through low-tensioned and two-body abrasive wear. The ratio between the hardness of the tools (Hs) and the hardness of the abrasive soil particles (Ha) determines wear mechanisms. When this ratio is lower than 0.8, microcutting and microplowing mechanisms are dominant. Meanwhile, when the hardness value of the tool's surface is close to or higher than the hardness value of the soil particles, microcracks, fragmentation, and peel-off of the hard phases occur. Therefore, hardness alone may not be sufficient to ensure tribological performance, and hardness and toughness should be balanced since tillage tools are exposed to movements such as impacts.
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    Effect of Quenching and Tempering Temperature on Corrosion Behavior of Boron Steels in 3.5 wt.% NaCl Solution
    Aydin, G; Yazici, A
    This study was carried out to examine the impact of austenitization and tempering temperatures on the corrosion characteristics of boron steels. Boron steel samples were austenitized at 850 degrees C, 900 degrees C, and 950 degrees C, and then quenched in environmental water. After quenching, the samples were tempered at 150 degrees C, 300 degrees C, and 450 degrees C for 30 minutes to prepare specimens. The corrosion characteristics of quenched and tempered boron steels in a 3.5 wt.% NaCl solution were examined using Tafel extrapolation method. Significant statistical differences have been observed between the tested boron steels in terms of corrosion rate. Changing C concentration affected the corrosion rates of boron steels after their immersion into a 3.5 wt% NaCl solution and increasing C content generally accelerated the corrosion rate. A poor correlation has been found between average ferrite grain size and corrosion rate under the examined heat treatment conditions for tested boron steels.
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    Investigation of the reduction of mouldboard ploughshare wear through hot stamping and hardfacing processes
    Yazici, A
    The effects of the hot stamping process and different hardfacing techniques, such as shielded metal arc welding (SMAW) and gas metal arc welding (GMAW), on the abrasive wear of ploughshares were investigated under field operational conditions. The abrasive wear losses were determined by measuring the weight and dimension changes before and after tillage. The wear losses of hot-stamped and hardfaced ploughshares were less significant than those of the conventionally heat-treated ploughshare specimens used under field conditions. Conventional heat treatment and hardfacing by the SMAW process decreased the wear weight losses by 46.31% and the dimensional losses by 86.77% in comparison to the performance of the conventionally heat-treated ploughshares. These values were 36.90% and 88.17%, respectively, for conventional heat treatment and hardfacing by the GMAW process. There were no statistically significant differences between the SMAW and GMAW hardfacing processes in terms of wear losses. Hot stamping and heat treatment applications on the ploughshare also decreased wear losses by 19.03% and dimension losses by 13.82% in comparison to the conventional heat treatment process. According to the results of the overall study, hot stamping and hardfacing by SMAW and GMAW processes can be recommended as efficient solutions for decreasing the wear losses of ploughshares.
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    Surface Characteristics and Distortion Analysis of the Case-Hardened Helical Gears: A Comparison of Different Case-Hardening Treatments
    Gençoglu, S; Yazici, A
    In this study, the effect of different case-hardening treatments on microstructure, hardness distribution, surface roughness parameters, and dimensional changes was investigated for helical-toothed gears made of 16MnCr5 and 21NiCrMo2 steels. Gas carburizing, gas carburizing-double quenching, low-pressure carburizing, and plasma-nitriding treatments were performed as case-hardening processes. The surface characteristics and distortion analyses of the case-hardened helical gears were examined using an optical microscope, hardness tester, profilometer, and micrometer. In order to ensure adequate pitting and bending strength, the required minimum effective case depth and minimum total case depth values were provided by the performed case-hardening treatments. In the gears, the largest dimensional increase after the heat treatments occurred at the end of the gas carburizing due to the long treatment times at high processing temperatures. The surface roughness values obtained through all performed case-hardening treatments necessitated the finishing processes.
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    WEAR BEHAVIOR OF CARBONITRIDE-TREATED PLOUGHSHARES PRODUCED FROM 30MnB5 STEEL FOR SOIL TILLAGE APPLICATIONS
    Yazici, A
    The effects of gaseous carbonitriding processes on wear characteristics of 30MnB5 steel were investigated. The matrix of the carbonitride treated samples has a better wear resistance compared to the substrates of the conventionally heat-treated sample in laboratory conditions. The carbonitriding treatment condition giving rise to the lowest wear weight loss with the pin-on-disc wear machine was selected in order to harden ploughshare specimens to be tested in field experiments. The carbonitriding process at 860 degrees C, with 0.9% C, and 0.6 m3/h NH(3) for 105 min and quenched in 60 degrees C oil followed by a 60 min tempering process at 140 degrees C decreased 14.65% of total wear weight loss and 26.47% of total wear dimension loss of the ploughshare specimens in comparison to the conventional heat treatment process in field operational conditions.
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    A STUDY OF SOIL TILLAGE TOOLS FROM BORONIZED SINTERED IRON
    Yazici, A; Çavdar, U
    Acomparative analysis of the properties of boronized sintered iron and quenched steels 30MnB5, 28MnCrB5 used for making soil tillage tools is performed. The microstructure, phase composition, hardness and strength characteristics of the materials are studied. The composition of the boride phase formed in the sintered iron after boronizing is determined by an x-ray method. The losses to abrasive wear are evaluated with the help of a device containing a special bin with a sample of abrasive soil.
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    Effect of quenching and tempering temperature on the tensile properties of low alloyed boron steel
    Aydin, G; Yazici, A
    The effect of quenching and tempering temperature on the tensile properties and the yield strength ratio of 30MnB5, 27MnCrB5, and 34MnB5 boron steel have been investigated. Quenching (Q) and tempering (T) temperatures varied in the range of 850 to 950 degrees C and 150 to 450 degrees C, respectively. The mechanical properties of quenched and tempered steel were examined with the application of the tensile test and hardness testing. The microstructure was characterized using optical microscopy and X-ray diffraction. The increase in Q & T temperatures resulted in a decrease in the ultimate tensile strength (UTS), yield strength (YS) and break strength (BS) values and an increase in the yield strength ratio. The tempering temperature was found to be more effective on the UTS, YS and BS values than was the austenitizing temperature. It was noted that the effect of tempering temperature is greater on the ultimate tensile than on the yield strength for the investigated low alloyed boron steel. The effect of the tempering temperature on the elongation to fracture is also greater than the effect on the uniform elongation. The yield strength ratio showed a tendency to increase with increasing tempering temperatures. It was raised considerably by increasing the tempering temperatures from 300 to 450 degrees C, while it remained at a similar level between 150 and 300 degrees C. The ratio of ultimate tensile strength and mean hardness decreased with increasing tempering temperatures for the tested varieties of steel. Increasing tempering temperature leads to an increase in yield strength ratio and a total
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    Identification of susceptibility loci for Takayasu arteritis through a large multi-ancestral genome-wide association study
    Ortiz-Fernández, L; Saruhan-Direskeneli, G; Alibaz-Oner, F; Kaymaz-Tahra, S; Coit, P; Kong, XF; Kiprianos, AP; Maughan, RT; Aydin, SZ; Aksu, K; Keser, G; Kamali, S; Inanc, M; Springer, J; Akar, S; Onen, F; Akkoc, N; Khalidi, NA; Koening, C; Karadag, O; Kiraz, S; Forbess, L; Langford, CA; McAlear, CA; Ozbalkan, Z; Yavuz, S; Çetin, GY; Alpay-Kanitez, N; Chung, S; Ates, A; Karaaslan, Y; McKinnon-Maksimowicz, K; Monach, PA; Ozer, HTE; Seyahi, E; Fresko, I; Cefle, A; Seo, P; Warrington, KJ; Ozturk, MA; Ytterberg, SR; Cobankara, V; Onat, AM; Duzgun, N; Bicakcigil, M; Yentür, SP; Lally, L; Manfredi, AA; Baldissera, E; Erken, E; Yazici, A; Kisacik, B; Kasifoglu, T; Dalkilic, E; Cuthbertson, D; Pagnoux, C; Sreih, A; Reales, G; Wallace, C; Wren, JD; Cunninghame-Graham, DS; Vyse, TJ; Sun, Y; Chen, HY; Grayson, PC; Tombetti, E; Jiang, LD; Mason, JC; Merkel, PA; Direskeneli, H; Sawalha, AH
    Takayasu arteritis is a rare inflammatory disease of large arteries. We performed a genetic study in Takayasu arteritis comprising 6,670 individuals (1,226 affected individuals) from five different populations. We discovered HLA risk factors and four non-HLA susceptibility loci in VPS8, SVEP1, CFL2, and chr13q21 and reinforced IL12B, PTK2B, and chr21q22 as robust susceptibility loci shared across ancestries. Functional analysis proposed plausible underlying disease mechanisms and pinpointed ETS2 as a potential causal gene for chr21q22 association. We also identified >60 candidate loci with suggestive association (p < 5 x 10(-s)) and devised a genetic risk score for Takayasu arteritis. Takayasu arteritis was compared to hundreds of other traits, revealing the closest genetic relatedness to inflammatory bowel disease. Epigenetic patterns within risk loci suggest roles for monocytes and B cells in Takayasu arteritis. This work enhances understanding of the genetic basis and pathophysiology of Takayasu arteritis and provides clues for potential new therapeutic targets.
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    The Efficacy and Safety of CT-P13 as First-line and Subsequent-line Therapy in Patients with Ankylosing Spondylitis: Real-life Data from TURKBIO Cohort
    Uslu, S; Gulle, S; Can, G; Senel, S; Capar, S; Dalkilic, HE; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanc, N; Birlik, M; Solmaz, D; Cefle, A; Goker, B; Yolbas, S; Krough, NS; Yilmaz, N; Erten, S; Bes, C; Soysal, O; Ozturk, MA; Haznedaroglu, S; Yavuz, S; Direskeneli, H; Onen, F; Sari, I
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    Efficacy and Safety of CT-P13 as First- and Second-Line Treatment in Patients with Ankylosing Spondylitis
    Uslu, S; Gülle, S; Sen, G; Capar, S; Senel, S; Dalkilic, E; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanc, N; Birlik, M; Solmaz, D; Cefle, A; Goker, B; Direskeneli, H; Yolbas, S; Krogh, NS; Yilmaz, N; Erten, S; Bes, C; Gündüz, OS; Oztürk, MA; Haznedaroglu, S; Yavuz, S; Onen, F; Sari, I
    Background/Objectives: CT-P13 is a biosimilar version of infliximab, a monoclonal antibody. In individuals with ankylosing spondylitis (AS), CT-P13 has been shown to be effective and to have a well-tolerated safety profile. The aim of this study was to evaluate the long-term drug persistence, safety, and efficacy of infliximab biosimilar CT-P13 in patients with AS undergoing first-line (1st-line) and later (>= 2nd-line) treatment in clinical practice. Methods: We performed an observational cohort study that included AS patients based on the biological drug database in the TURKBIO Registry between 2014 and 2021. The patients were divided into two groups: those receiving CT-P13 as first-line treatment or as a switch (>= 2nd-line) from another TNF inhibitor (TNFi). Standard disease activity metrics were used to assess the effectiveness of CT-P13, and drug retention rates were investigated. Results: There were 179 AS patients using CT-P13 (47.4% male, mean age: 42.9 +/- 11.3 years). Of these patients, 123 (68.7%) were receiving CT-P13 as a first-line treatment. The mean length of treatment was 3.5 years. CT-P13 drug retention rates in the general patient population were 58.6% and 48.2% in the first-line and >= second-line treatment, respectively, after 3 years of follow-up. The most common reason for CT-P13 treatment discontinuation was lack of efficacy. The first-line CT-P13 group had statistically substantially higher ASAS20/40 response rates at three and six months. Nonetheless, both groups' response rates at one year were comparable. Conclusions: In this real-world data analysis, AS patients who were TNFi na & iuml;ve (1st-line) and subsequently treated (>= 2nd-line) with CT-P13 showed encouraging drug retention rates with acceptable long-term effectiveness and safety.
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    Efficacy and Safety of Secukinumab in the Treatment of Axial Spondyloarthritis: Real-Life Data from TURKBIO Cohort
    Gulle, S; Karakas, A; Can, G; Senel, S; Capar, S; Dalkilic, HE; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanc, N; Birlik, M; Solmaz, D; Cefle, A; Goker, B; Yolbas, S; Krough, NS; Yilmaz, N; Erten, S; Bes, C; Soysal, O; Ozturk, MA; Haznedaroglu, S; Yavuz, S; Direskeneli, H; Onen, F; Sari, I
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    A real-life analysis of patients with rheumatologic diseases on biological treatments: Data from TURKBIO Registry
    Önen, F; Can, G; Çapar, S; Dalkiliç, E; Pehlivan, Y; Senel, S; Akar, S; Koca, SS; Tufan, A; Yazici, A; Yilmaz, S; Inanç, N; Sari, I; Birlik, M; Solmaz, D; Cefle, A; Öztürk, MA; Yolbas, S; Krogh, NS; Yilmaz, N; Erten, S; Bes, C; Gündüz, ÖS; Göker, B; Haznedaroglu, S; Yavuz, S; Çetin, GY; Yildiz, F; Direskeneli, H; Akkoç, N
    Objective: TURKBIO registry, established in 2011, is the first nationwide biological database in Turkey. This study aimed to provide an overview of TURKBIO data collected by June 2018. Methods: The registry included adult patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-AxSpA), and psoriatic arthritis (PsA). Demographic and clinical features, disease activity markers, and other follow-up parameters, current and previous treatments, and adverse events were registered electronically at each visit using open-source software. The registration of patient-reported outcome measures was carried out electronically by the patients using touch screens. Results: TURKBIO registry included a total of 41,145 treatment series with biologicals. There were 2,588 patients with axSpA (2,459 AS and 129 nr-axSpA), 2,036 with RA, and 428 with PsA. The total number of patients, including those with other diagnoses, was 5,718. In the follow-up period, the number of patients and also visits steadily increased by years. The yearly mean number of visits per patient was found to be 2.3. Significant improvements in disease activity and health assessment parameters were observed following the biological treatments. Biologics were often given in combination with a conventional synthetic disease-modifying antirheumatic drug in patients with RA. Infections were the most commonly seen adverse events, followed by allergic reactions. Tuberculosis was observed in 12 patients, malignancy in 18, and treatment-related mortality in 31. Conclusion: TURKBIO provided a valuable real-life experience with the use of biologics in rheumatic diseases in Turkey.
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    UNINTENTIONAL MONOTHERAPY IN RHEUMATOID ARTHRITIS PATIENTS RECEIVING TOFACITINIB AND DRUG SURVIVAL RATE OF TOFACITINIB
    Inanc, N; Abacar, K; Ozturk, MA; Tufan, A; Karadeniz, H; Sari, I; Can, G; Erez, Y; Pehlivan, Y; Dalkiliç, E; Ocak, T; Cefle, A; Yazici, A; Senel, A; Akar, S; Ediboglu, ED; Koca, SS; Sagir, RP; Yilmaz, S; Gulcemal, S; Gündüz, ÖS; Basibüyük, CS; Alkan, S; Cesur, TY; Onen, F
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    A national, multicenter, secondary data use study evaluating efficacy and retention of first-line biologic treatment with tocilizumab in patients with rheumatoid arthritis in real-life setting: results from TURKBIO registry
    Yazici, A; Isik, ÖÖ; Dalkiliç, E; Koca, SS; Pehlivan, Y; Senel, S; Inanc, N; Akar, S; Yilmaz, S; Gündüz, ÖS; Cefle, A; Karakas, ÖF; Onen, F
    Tocilizumab (TCZ) is a recombinant humanized monoclonal antibody that targets the IL-6 receptor. TCZ found to be efficacious and has a good tolerated safety profile in rheumatoid arthritis (RA) patients. The aim of this study was to describe the disease activity and retention rate in Turkish RA patients who were prescribed TCZ as first-line biologic treatment in a real-world setting. Secondary data obtained from adult RA patients' files was used in a multicenter and retrospective context. Clinical Disease Activity Index (CDAI), Disease Activity Score in 28 joints with ESR (DAS28-ESR), and retention rates of TCZ were evaluated at related time points. 130 patients (87.7% female) with a mean age of 53 years (SD; 15.0) were included in the study. Mean RA duration was 14 years and median duration of follow-up was 18.5 months. Number of patients with ongoing TCZ treatment at 6, 12, and 24 months were 121 (93%), 85 (65%), and 46 (35%), respectively. Remission rates at 6, 12, and 24 months per CDAI (<2.8) and DAS28-ESR (<2.6) scores were 61.5, 44.6, 30%, and 54.6, 40.8, 27.7%, respectively. Both CDAI and DAS28-ESR scores significantly improved at 6, 12 and 24 months (p<0.001 for both). At 24 months, 23 patients (17.6%) discontinued TCZ, of whom majority (17/23) were due to unsatisfactory response. Retention rates of TCZ at 6, 12, and 24 months were 93, 84.3, and 72.2%, respectively. In this real-world study, TCZ as a first-line biologic therapy was found to be efficacious and showing high retention rates. These real-world study results are in line with previous randomized studies.
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    DISEASE DURATION AND HLA-B27 POSITIVITY ALTER LONGTERM RETENTION RATE OF CERTOLIZUMAB PEGOL IN PATIENTS WITH PSORIATIC ARTHRITIS
    Koca, SS; Pehlivan, Y; Akar, S; Senel, S; Karadeniz, H; Sosyal, O; Yazici, A; Yilmaz, S; Sagir, RP; Inanc, N; Karatas, A; Cetin, GY; Onen, F
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    The impact of smoking on response to tumor necrosis factor-α inhibitor treatment in patients with ankylosing spondylitis
    Tugsal, HY; Kenar, G; Can, G; Çapar, S; Zengin, B; Akar, S; Dalkiliç, E; Senel, S; Koca, SS; Goker, B; Yazici, A; Inanç, N; Ellidokuz, H; Akkoç, N; Önen, F
    Background/aim: To investigate the impact of smoking on disease activity, treatment retention, and response in patients with ankylosing spondylitis (AS) treated with their first tumor necrosis factor-alpha inhibitor (TNFi). Materials and methods: AS patients who started their first TNFi treatment for the active axial disease (BASDAI >= 4) from TURKBIO Registry were included. Treatment response of smoker (current and ex-smokers) and nonsmoker (never smoker) patients were primarily evaluated as achievement of BASDAI50 or improvement in BASDAI at least 20 mm at 3 months and 6 months compared to baseline. Results: There were 322 patients with AS (60% male, 59% smoker, mean age: 38.3 years). The median follow-up time was 2.8 years (Q1-Q3: 1.3-3.8), and disease duration was 3.5 years (Q1-Q3: 0.7-8.2). Smokers had male predominance (p < 0.001), lower ESR (p = 0.03), higher BASDAI (p = 0.02), BASFI (p = 0.05), HAQ-AS (p = 0.007), and ASDAS-CRP (p = 0.04) compared with nonsmokers at baseline. In the multivariate analysis, male gender [OR 2.7 (95%CI 1.4-5), p = 0.002], and concomitant conventional synthetic disease-modifying antirheumatic drug use [OR 2.4 (95%CI 1.1-5.2), p = 0.03] were associated with better treatment response. There was an association of male gender [HR 2.4 (95%CI 1.6-3.7), p < 0.001], older age (>= 30years) [HR 1.8 (95%CI 1.1-2.8), p = 0.01], and response to treatment [HR 1.8 (95%CI 1.2-2.9), p = 0.008] with better treatment retention. No impact of smoking status was found on treatment retention and response in univariate and multivariate analyses. Conclusion: This study suggested that smoking was associated with poorer patient-reported outcomes in biologic naive AS patients initiating their first TNFi treatment, but it had no impact on the TNFi treatment response and retention rate.
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