Heavy? Less Likely to Have RA Remission

A new study has found that overweight and obese patients are less likely to achieve successful remission in early rheumatoid arthritis (ERA) compared to those of normal weight. Obese and overweight ERA subjects required 2.4 times more anti-TNF therapy throughout the study than normal weight participants without achieving similar remission outcomes.

A total of 346 ERA patients with symptom duration <12 months were categorized into one of three BMI (body mass index) classes—normal weight, overweight and obese—and treated according to a treat-to-target strategy aimed at remission. The strategy included strict follow-up visits, treatment with methotrexate up to 25mg/week+steroids, and combination with a TNF blocker if at least a good response according to EULAR (European League Against Rheumatism) criteria was not obtained.

Those who were overweight and obese patients reached a lower rate of remission at 6- and 12-month follow-up visits. A higher percentage of obese and overweight ERA patients were under anti-TNF treatment after 12 months of follow-up compared to normal weight.

“Obesity and rheumatoid arthritis are both on the rise, with devastating effects on individuals and society as a whole. These data reinforce the link between obesity and inflammation, and establish that BMI is one of the few modifiable variables influencing the major outcomes in RA, ” said Elisa Gremese, Division of Rheumatology, Institute of Rheumatology and Affine Sciences, Catholic University of the Sacred Heart, Rome, in the June 14, 2013 news release. “There is an urgent need to address the issues of overweight and obesity to improve patients’ chance of successful remission.”