Effect of significant weight loss on disease activity: reason to implement this non-pharmaceutical intervention in daily clinical practice

Weijers, Julia M; Müskens, Wieland D; Riel, P.L.C.M. van

doi:10.1136/rmdopen-2020-001498

Cited by 16 publications

(7 citation statements)

References 21 publications

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“…Obesity was associated with worse disease activity and disease management in both PsA and RA [ 12 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ] and a detrimental response to anti-tumor necrosis factor alpha (anti-TNF) treatments [ 15 , 17 , 18 ]. Additionally, despite the association of weight loss with a better disease outcome in PsA patients [ 22 , 23 ], a low BMI (underweight) was associated with worse RA disease activity [ 10 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Psoriatic Arthritis and Rheumatoid Arthritis Patients across Body Mass Index Categories in Switzerland

Vallejo-Yagüe

Burkard

Möller

et al. 2021

JCM

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Abnormal body mass index (BMI) was associated with worse rheumatic markers in psoriatic arthritis (PsA) and rheumatoid arthritis (RA). Aiming to describe PsA and RA patients stratified by BMI, we performed a descriptive study in PsA and RA patients (two distinct cohorts) in the Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) registry. New users of biologic or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) were stratified by BMI at the start of their treatment (underweight, normal weight, overweight, obese). The PsA underweight and normal weight categories were merged. Age at disease onset and further characteristics at the start of the first b/tsDMARD treatment were compared across BMI categories vs. the corresponding normal weight group. The study included 819 PsA (36.5% overweight, 23.8% obese) and 3217 RA patients (4.4% underweight, 31.8% overweight, 17.0% obese). Compared to the corresponding normal weight group, PsA and RA obese patients had significantly (p < 0.05) higher C-reactive protein, worse disease activity, and lower quality of life (QoL). Obese PsA patients had significantly worse skin manifestation and pain, while obese RA patients had significantly higher erythrocyte sedimentation rate and tender joint counts, as well as lower seropositive prevalence. To conclude, obese PsA and RA patients presented worse disease activity and poorer QoL than those with normal weight.

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Section: Introductionmentioning

confidence: 99%

Comparison of Psoriatic Arthritis and Rheumatoid Arthritis Patients across Body Mass Index Categories in Switzerland

Vallejo-Yagüe

Burkard

Möller

et al. 2021

JCM

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“…Obesity is associated with complications in diverse autoimmune diseases and is very common in patients with inflammatory rheumatic diseases, of which 27% and 37% of patients with rheumatoid and psoriatic arthritis, respectively have a body mass index ≥30 kg/m 2 [ 24 ]. In patients with SLE, the frequency of obesity is similar or higher than that in the general population, with a prevalence ranging from 28% to 50%, and it has been implicated as a risk factor for exacerbation of clinical manifestations of disease and inflammatory processes [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another study supported the hypothesis that obesity promotes disease activity in psoriatic arthritis [ 29 ]. In inflammatory rheumatic diseases, it has been hypothesized that patients with obesity tend to have low response rates for antirheumatic drugs (conventional synthetic disease-modifying antirheumatic drugs) and biological drugs [ 24 ]. A study with patients with rheumatic diseases suggests that patients with obesity may require more time of treatment to achieve minimal activity disease [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of overweight and obesity on disease activity and remission in systemic lupus erythematosus: A systematic review and meta-analysis protocol

et al. 2023

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Background Systemic lupus erythematosus (SLE) is an autoimmune and inflammatory disease that requires treatment with hydroxychloroquine and glucocorticoids. Glucocorticoids are responsible for adverse effects such as increased weight, which can modify the severity and chronicity of autoimmune pathologies. Aim To summarize scientific evidence regarding the impact of overweight and obesity on disease activity and remission in SLE. Methods The protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocol (PRISMA-P) and published in the International Prospective Register of Systematic Reviews database (PROSPERO—CRD42021268217). PubMed, Scopus, Embase, and Google Scholar will be searched for observational studies including adult patients with SLE who were overweight and obese or not, that included disease activity or remission as outcomes. The search is planned for May 2023. Three independent authors will select the eligible articles and extract their data. Subsequently, three authors will independently extract data from each included study using an extraction form created by the researchers. Methodological quality analyses will be performed using the modified Newcastle-Ottawa scale. The results will be presented as a narrative synthesis according to the synthesis without a meta-analysis reporting guideline (SWiM). Meta-analysis will be conducted where appropriate using random-effects models. Expected results This review will identify the impact of overweight and obesity on the clinical features of SLE, helping clinicians manage disease activity and remission, both important to optimize disease outcomes and patient quality of life.

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“…Two-thirds of rheumatoid arthritis patients are overweight or have obesity. Weight gain in such a group of patients can be associated with higher disease activity and poor response to treatment [7].…”

Section: Discussionmentioning

confidence: 99%

Weight Gain in Seropositive Rheumatoid Arthritis Patients Treated With Anti-tumor Necrosis Factor (TNF) Therapy

Alsulaim¹,

Almulla²,

Alotaibi³

et al. 2022

Cureus

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IntroductionRheumatoid arthritis and its treatment have different effects on weight gain. This study examined the effect of tumor necrosis factor (TNF) inhibitors on weight gain in patients with seropositive rheumatoid arthritis compared with non-TNF therapy and disease activity. MethodsA retrospective cohort study was conducted in Prince Mohammad bin Abdulaziz Hospital for all patients aged ≥ 18-year-old diagnosed with seropositive rheumatoid arthritis and started on TNF inhibitors or non-TNF biologics in outpatient clinics since 2015. Patients were excluded if they were pregnant, had an uncontrolled underlying metabolic disease, were post-bariatric, or had a history of malabsorption. We also excluded individuals on treatment for congestive heart failure or end-stage renal disease. ResultsA total of 116 patients with rheumatoid arthritis were reviewed between 2015 and 2019. Only 69 patients met the inclusion criteria (51 and 18) in the TNF-a (alpha) and non-TNF-a inhibitor groups, respectively. The weight change from pre-treatment to post-treatment showed an average increase of 1.2 kg (95% CI: -0.68-3.17) in the TNF-a inhibitor group while in the non-TNF-a inhibitor group, the average increase in weight was 2.67 kg (95% CI: -0.44-5.78). Over the period of two years, there was no statistical difference in weight gain in both groups or in relation to disease activity. ConclusionThe results of this study did not show a significant increase in weight gain in seropositive patients with rheumatoid arthritis who were treated with TNF or non-TNF inhibitors.

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Effect of significant weight loss on disease activity: reason to implement this non-pharmaceutical intervention in daily clinical practice

Cited by 16 publications

References 21 publications

Comparison of Psoriatic Arthritis and Rheumatoid Arthritis Patients across Body Mass Index Categories in Switzerland

Comparison of Psoriatic Arthritis and Rheumatoid Arthritis Patients across Body Mass Index Categories in Switzerland

Impact of overweight and obesity on disease activity and remission in systemic lupus erythematosus: A systematic review and meta-analysis protocol

Weight Gain in Seropositive Rheumatoid Arthritis Patients Treated With Anti-tumor Necrosis Factor (TNF) Therapy

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