Obesity and the prediction of minimal disease activity: A prospective study in psoriatic arthritis

Abstract

Objective. We prospectively evaluated whether obesity impacts achievement of minimal disease activity (MDA) in subjects with psoriatic arthritis (PsA). Methods. Among PsA subjects with an active disease and who were starting a treatment with tumor necrosis factor ␣ blockers, 135 obese (body mass index [BMI] >30 kg/m 2 ) patients and 135 patients of normal weight (controls) were followed up for 24 months. At baseline and at the 12-and 24-month followup, all subjects underwent a clinical, rheumatologic, and laboratory assessment. Results. With the exception of the prevalence of hypercholesterolemia and hypertriglyceridemia, case and control subjects were similar for all the clinical and demographic characteristics analyzed. At the 12-month followup, in both cases and controls, no significant changes in body weight were found (P > 0.05 for all). MDA was achieved by 98 (36.3%) of the 270 PsA individuals. The prevalence of obesity was higher in those that did not achieve MDA than in those that did (64.0% versus 25.5%; P < 0.001). After adjusting for all the other variables, obesity was associated with a higher risk of not achieving MDA (hazard ratio [HR] 4.90, 95% confidence interval [95% CI] 3.04 -7.87; P < 0.001). The HR of not achieving MDA was 3.98 (95% CI 1.96 -8.06, P < 0.001) and 5.40 (95% CI 3.09 -9.43, P < 0.001) in subjects with first-degree (BMI <30 kg/m 2 ) and second-degree (BMI 30 -35 kg/m 2 ) obesity, respectively. Among the 98 subjects who had achieved MDA at the 12-month followup, the presence of obesity was associated with a poor probability of sustained MDA at the 24-month followup (HR 2.04, 95% CI 1.015-3.61; P ‫؍‬ 0.014). Conclusion. Obesity is a negative predictor of achieving and maintaining MDA.

Body Mass Index and response to rituximab in rheumatoid arthritis

“…Recent reports showed a negative association between BMI and response to anti-TNF␣ therapies, notably infliximab (IFX), in RA [13][14][15], psoriatic arthritis [16,17] and ankylosing spondylitis (AS) [18,19], which suggests that fat mass may affect the response to biologic agents. BMI might be a predictive factor of IFX response in RA, but no study has evaluated the impact of BMI on rituximab (RTX) response in RA.…”

The impact of concomitant diffuse idiopathic skeletal hyperostosis on the achievement of minimal disease activity in subjects with psoriatic arthritis

“…An increasing BMI is a recognized predictor of DISH [10], and it is also a negative predictor of MDA BMI body mass index, BASDAI bath ankylosing spondylitis disease activity index, BASFI bath ankylosing spondylitis functional index, BASMI bath ankylosing spondylitis metrology index, ESR erythrocyte sedimentation rate, CRP C-reactive protein, TJC tender joint count, SJC swollen joint count, TEC tender entheseal count, PASI psoriasis area and severity index, VAS-p visual analog scale-pain, VAS-g visual analog scale-global disease activity, HAQ health assessment questionnaire a Univariate analysis b Multivariate analysis [15,16]. Weather the reduced prevalence of MDA achievement in PsA patients with DISH could be secondary to the higher BMI cannot be definitely addressed based on present results.…”

Liver Damage in Psoriasis and Psoriatic Arthritis: A Literature Review

“…Частота ожи-рения среди больных, которые не достигли МАБ, была выше, чем среди тех, у кого она была достигнута (64,0 и 25,5% соответственно; р<0,001). После поправки на все остальные переменные был сделан вывод, что ожи-рение связано с повышенным риском недостижения МАБ (ОШ=4,90; 95% ДИ 3,04-7,87; р<0,001) [56].…”