Clinical outcomes of thyroid eye disease in smokers and vapers: a single centre observational comparator study
Author: Tejaswi Bommireddy
Base Hospital / Institution: King’s College Hospital NHS Foundation Trust
Rapid fire oral presentation
Abstract ID: 25-348
Purpose
E-cigarette use has increased in recent years, but its effects on thyroid eye disease (TED) has not yet been evaluated.
Methods
Single-centre, observational, comparator study of active or ex-smoker adults (≥18 years) with TED, categorised into: “ex-smokers” (no smoking or vaping), “smokers” (smoking but no vaping), “vapers” (vaping but no smoking), and “smoke-vapers” (both smoking and vaping), at presentation; exposure was measured by retrospective questionnaires. Standardised grades for inflammatory index (II) and TED severity were derived from TED-specific clinic proformas or patient records to evaluate clinical outcomes, reported at first and last visit. Data was summarised as count, means (standard deviation, SD), or medians [interquartile range, IQR] and change in outcomes as mean (95% confidence interval, CI) difference. t-test was used to compare mean difference. Analyses were undertaken with STATA MP v18.5 (Texas, United States).
Results
In total, 42 patients were analysed; 24 ex-smokers, 6 smokers, 5 vapers, and 7 smoke-vapers. The mean (SD) pack years for ex-smokers, smokers, vapers and smoke-vapers were 8.7 (11.0), 19.7 (17.0), 5.9 (1.3), and 20.4 (12.0). Almost half of each group stopped smoking or vaping during follow up. The mean (SD) baseline II and TED severity in ex-smokers, smokers, vapers and smoke-vapers was 2.9 (2.4), 2.3 (2.4), 2.0 (2.8), and 3.5 (3.3); and 1.6 (0.6), 1.5 (0.3), 1.4 (0.5) and 1.7 (0.5) respectively. At final follow up, the mean difference (95% CI) in II and TED severity for these groups was -2.1 (-3.2 – -0.98), -2.0 (-7.0 – 3.0), -2.5 (-7.3 – 2.3) and -2.0 (-6.1 – 2.1); and -0.33 (-0.57 – -0.09), -0.25 (-1.0 – 0.55), -0.20 (-0.76 – 0.36) and -1.4 (-1.9 – 0.93) respectively. A statistically significant reduction (p<0.05) was only found in the ex-smoker group.
Conclusion
Smoking cessation is essential in TED. Individuals who vape may have less severe disease at TED onset, but not if they combine vaping and smoking. Prospective, controlled studies are needed to better evaluate the dose-response relationship between vaping and smoke-vaping in TED.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Amy | Chen | University of Auckland |
| Chan Ning | Lee | King’s College Hospital NHS Foundation Trust |
| Stuti | Misra | University of Auckland |
| Richard | Hart | Greenlane Clinical Centre |
