Smoking Interferes with Antimalarial Therapy

Over the last several years, I have reported on studies of antimalarial therapy in patients with cutaneous lupus erythematosus (CLE) and the impact of smoking on the effectiveness of this therapy. (See, for example, NEJM JW Dermatol June 2014 and Br J Dermatol 2014 Mar 26; [e-pub].) Since this topic was first introduced into the literature in 1998, multiple observational studies, most retrospective, have suggested that smoking interferes with antimalarials' effects. In addition, findings of a few studies imply that smokers might have more active disease than nonsmokers. The bottom line of this past coverage has been that smoking is bad for health, so it is unimportant whether smoking lessens the effect of antimalarial therapy or leads to mo…