Obesity is a risk factor for poor remission rates in RA

(HealthDay) -- For patients with long-standing rheumatoid arthritis treated with anti-tumor necrosis factor-α (anti-TNFα) therapies, obesity is related to poor remission rates, according to a study published online June 21 in Arthritis Care & Research.

Elisa Gremese, M.D., of the Catholic University of the Sacred Heart in Rome, and colleagues conducted a study involving 641 outpatients with long-standing rheumatoid arthritis receiving anti-TNFα blockers (260 treated with adalimumab, 227 with etanercept, and 154 with infliximab) to examine the impact of obesity on remission. Patients were recruited from 2006 to 2009 and monitored for 12 months or longer.

The researchers found that, at baseline, 10.3 percent of patients had a body mass index (BMI) in excess of 30 kg/m², and the disease activity score (DAS28) was 5.6 ± 1.4. After 12 months of anti-TNFα treatment, 15.2 percent of obese patients had a DAS28 below 2.6, compared with 30.4 percent of patients with a BMI of 25 to 30 kg/m² and 32.9 percent of patients with a BMI of less than 25 kg/m² (P = 0.01). Infliximab was associated with the lowest percentage of remission, which was significantly lower than either etanercept or adalimumab.

"Obesity represents a risk factor for a poor remission rate in long-standing rheumatoid arthritis treated with anti-TNFα," the authors write. "A personalized treatment might be a possible solution."

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