Body Mass Index and response to rituximab in rheumatoid arthritis

Ottaviani, Sébastien; Gardette, Anaïs; Roy, Carine; Tubach, Florence; Gill, Ghislaine; Palazzo, Élisabeth; Meyer, Olivier; Dieudé, Philippe

doi:10.1016/j.jbspin.2015.02.011

Cited by 54 publications

(61 citation statements)

References 33 publications

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“…Pers et al did not find a difference in the frequency of remission in obese (41%) compared to overweight (28%) or normal‐weight (46%) BMI categories , but remission was less frequent in obese patients in studies by Iannone et al (17% in obese versus 38% in normal‐weight patients) , Ellerby et al (3% in obese versus 13% in nonobese patients) , and Gremese et al (15% in obese versus 32% in nonobese patients) . Ottaviani et al did not find an association between increasing BMI and remission . Four studies reported the OR for obese subjects achieving remission after adjusting for important confounders .…”

Section: Resultsmentioning

confidence: 92%

Impact of Obesity on Remission and Disease Activity in Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

Liu

Hazlewood

Kaplan

et al. 2016

Arthritis Care & Research

168

114

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Section: Resultsmentioning

confidence: 92%

Impact of Obesity on Remission and Disease Activity in Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

Liu

Hazlewood

Kaplan

et al. 2016

Arthritis Care & Research

168

114

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“…A French study found that obese patients were 83% less likely to attain a DAS28 decrease of ≥1.2 after 6 months of follow-up (28). In the Better Anti-Rheumatic Farmacotherapy (BARFOT) study, obesity was associated with 50% lower odds of sustained remission by DAS28 (OR 0.51, 95% CI 0.32–0.84) and worse mHAQ scores compared to non-obese patients (13).…”

Section: Discussionmentioning

confidence: 99%

Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data

Kreps¹,

Halperin²,

Desai³

et al. 2018

ISSN 1758-4272 Int. J. Clin. Rheumatol

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Objective To evaluate the association between weight loss and rheumatoid arthritis (RA) disease activity. Methods We conducted a retrospective cohort study of RA patients seen at routine clinic visits at an academic medical center, 2012–2015. We included patients who had ≥2 clinical disease activity index (CDAI) measures. We identified visits during follow-up where the maximum and minimum weights occurred and defined weight change and CDAI change as the differences of these measures at these visits. We defined disease activity improvement as CDAI decrease of ≥5 and clinically relevant weight loss as ≥5 kg. We performed logistic regression analyses to establish the association between improved disease activity and weight loss and baseline BMI category (≥25 kg/m2 or <25 kg/m2). We built linear regression models to investigate the association between continuous weight loss and CDAI change among patients who were overweight/obese at baseline and who lost weight during follow-up. Results We analyzed data from 174 RA patients with a median follow-up of 1.9 years (IQR 1.3–2.4); 117 (67%) were overweight/obese at baseline, and 53 (31%) lost ≥5 kg during follow-up. Patients who were overweight/obese and lost ≥5 kg had three-fold increased odds of disease activity improvement compared to those who did not (OR 3.03, 95%CI 1.18–7.83). Among those who were overweight/obese at baseline, each kilogram weight loss was associated with CDAI improvement of 1.15 (95%CI 0.42–1.88). Our study was limited by using clinical data from a single center without fixed intervals for assessments. Conclusion Clinically relevant weight loss (≥5 kg) was associated with improved RA disease activity in the routine clinical setting. Further studies are needed for replication and to evaluate the effect of prospective weight loss interventions on RA disease activity.

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“…Notable among these studies is an analysis of the BeST trial, showing lower response rates to initial treatment in patients with BMI ≥25 kg/m 2 [30•], and a large Swedish study of DMARD-naïve patients, most treated with methotrexate, in which patients with obesity were significantly less likely to achieve low disease activity at 3 and 6 months [31••]. While small studies have shown no differences in response rates to rituximab or tocilizumab, larger studies are needed to verify these results [35, 36]. At this time, there is no sufficient evidence to suggest that obesity is associated with poor response to a specific class of medications or to support individualizing treatment decisions based on BMI.…”

Section: Obesity Disease Activity and Treatment Responsementioning

confidence: 99%

The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care

George

Baker

2016

Curr Rheumatol Rep

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With the prevalence of obesity increasing dramatically worldwide over the past several decades, an increasing body of literature has examined the impact of obesity in the context of rheumatoid arthritis (RA). Epidemiologic studies suggest that obesity may be associated with a modestly increased risk for the development of RA, although these studies have shown conflicting results. Among patients with established RA, obesity has been observed to be associated with greater subjective measures of disease activity and poor treatment response, but also with a decreased risk of joint damage and lower mortality. A comprehensive evaluation of the influence of obesity on the measurement of disease, response to therapies, and long-term prognosis is critical in order to understand these observations. This review therefore focuses on recent observations, potential explanations for these findings, and implications for clinicians and investigators caring for and studying patients with RA.

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Body Mass Index and response to rituximab in rheumatoid arthritis

Cited by 54 publications

References 33 publications

Impact of Obesity on Remission and Disease Activity in Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

Impact of Obesity on Remission and Disease Activity in Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data

The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care

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