Corrigendum to: Obesity reduces the real-world effectiveness of cytokine-targeted but not cell-targeted disease-modifying agents in rheumatoid arthritis

Schäfer, Martin; Meißner, Yvette; Kekow, Jörn; Berger, Sylvia; Remstedt, Sven; Manger, Bernhard; Listing, Joachim; Strangfeld, Anja; Zink, Angela

doi:10.1093/rheumatology/keaa049

Cited by 4 publications

(2 citation statements)

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“…Some prior reports have suggested that obesity may be associated with a reduced response to the initiation of a TNFi therapy 5 7. Obesity has also been associated with reduced response to other biologic and conventional therapies,4 6 8 24 although not necessarily for JAKi 25. A limitation of many prior studies has been the lack of comparator arm, which limits the ability of studies to determine whether obesity is associated with reduced response in general , versus a reduced response to a particular therapy , as demonstrated within a single trial.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies have considered how body mass index (BMI) might influence responses to disease-modifying anti-rheumatic drugs (DMARDs) in patients with RA. Several studies have shown that obesity and overweight are associated with reduced responses to biologic DMARDs and a lower likelihood of achieving low disease activity (LDA) overall 2–9. However, while some studies suggest that treatment responses may be reduced among those with excess weight, few studies have directly compared two active treatment strategies and thus limited evidence is available for clinicians making these clinical decisions.…”

Section: Introductionmentioning

confidence: 99%

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Lower body mass and lower adiposity are associated with differential responses to two treatment strategies for rheumatoid arthritis

Baker,

ODell,

England

et al. 2024

Ann Rheum Dis

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PurposeTo determine if body mass index (BMI) and adipokine levels identify rheumatoid arthritis (RA) patients most likely to benefit from initiation of tumour necrosis factor inhibitors (TNFi) after methotrexate inadequate response.MethodsThis is a secondary analysis of the Rheumatoid Arthritis Comparison of Active Treatments (RACAT) trial and the (TEAR) trial. Both studies compared treatment strategies starting with conventional disease-modifying anti-rheumatic drugs (DMARDs) (triple therapy) versus etanercept plus methotrexate. We compared response rates between TNFi and triple therapy among patients with different BMI. Adipokines were measured at enrolment and associations with treatment response were examined using regression, adjusting for age, sex, BMI and baseline disease activity.ResultsIn RACAT (n=306), participants who were normal/underweight were more likely to benefit from TNFi versus triple therapy, with greater change in Disease Activity Score in 28 and greater ACR20 response (ACR 20: 64% vs 23%, p=0.001). In contrast, overweight/obese participants had similar response to TNFi versus triple therapy (p-for-interaction=0.001). Similarly, but modest patterns were observed in TEAR (n=601; ACR20: 67% vs 52%, p=0.05). In RACAT, adipokine scores consistent with lower adiposity also predicted greater response to TNFi (ACR20: 58% vs 37%, p=0.01) with better model fit compared with BMI alone.ConclusionsLower BMI and evidence of lower adiposity based on adipokine profiles were associated with a superior response to TNFi compared with triple therapy. There was no difference between treatments among overweight/obese participants. The results support TNFi being a particularly important therapeutic among normal/underweight patients, with implications for clinical decisions and trial design.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lower body mass and lower adiposity are associated with differential responses to two treatment strategies for rheumatoid arthritis

Baker,

ODell,

England

et al. 2024

Ann Rheum Dis

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The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis

2020

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Optimising Response to Advanced Therapies in Rheumatoid Arthritis – Using Prehabilitation to Improve Success?

Mason

Malik

2020

EMJ Rheumatol

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In recent years, a new concept of prehabilitation, enhancing an individual’s functional capacity ahead of a medical intervention, has begun to be explored in the fields of surgery and oncology, with positive results. This article explores applying the principle of prehabilitation to patients with rheumatoid arthritis prior to starting advanced therapies, including biologic disease-modifying antirheumatic drugs and targeted synthetic disease-modifying antirheumatic drugs. In this article, the literature is reviewed and the existing evidence is summarised, and the suggestion is that this approach could improve a patient’s chance of achieving low disease activity or remission. There are a number of opportunities for improving the likelihood of patients with rheumatoid arthritis having a good response to therapy. Research shows that smokers starting TNF inhibitors are less likely to achieve a good response compared to non-smokers. Obese patients are also less likely to achieve a good response with TNF inhibitors; female patients with obesity may be less likely to achieve a good response with tocilizumab and early real-world data suggest there may be a reduced response to JAK inhibitors. Rheumatoid arthritis patients experiencing depression are less likely to respond to TNF inhibitors. Increased physical activity is potentially beneficial for all rheumatoid arthritis patients, although the effect on response to specific drugs has been less widely explored. Prehabilitation approaches could include targeting smoking cessation, improving physical activity, providing psychological support, optimising BMI, and dietary changes. A number of studies have shown that each of these interventions can lead to significant improvements in disease activity scores, with some patients potentially benefitting from more than one intervention. The authors identify principles for delivering prehabilitation in practice and suggest that this is an exciting area for ongoing research.

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Corrigendum to: Obesity reduces the real-world effectiveness of cytokine-targeted but not cell-targeted disease-modifying agents in rheumatoid arthritis

Cited by 4 publications

References 0 publications

Lower body mass and lower adiposity are associated with differential responses to two treatment strategies for rheumatoid arthritis

Lower body mass and lower adiposity are associated with differential responses to two treatment strategies for rheumatoid arthritis

The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis

Optimising Response to Advanced Therapies in Rheumatoid Arthritis – Using Prehabilitation to Improve Success?

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