OBJECTIVE: The objective of this study was to determine whether BMI and gender could lead to a different response rate to anti-TNF agents in patients affected by axial SpA. METHODS: One hundred and seventy patients with active axial SpA (defined as a BASDAI ≥ 4) treated with an anti-TNF agent [adalimumab (ADA), etanercept (ETA), infliximab (IFX)] were retrospectively evaluated. Patients were divided according to the baseline BMI as normal weight (BMI < 25), overweight (BMI 25-30) and obese (BMI ≥ 30). After 12 months of treatment a 50% improvement of the initial BASDAI (BASDAI50) was the primary end point and BASDAI ≤ 1 was the secondary end point. RESULTS: After 12 months of anti-TNF treatment, 67.8% of men and 46.2% of women reached the BASDAI50 (P = 0.01). According to BMI categories, the rate of BASDAI50 achievement decreased from 72.8% in normal weight subjects to 54.5% in overweight and 30.4% in obese subjects (P < 0.001). In the logistic regression analysis, the best independent predictors of failure to obtain a BASDAI50 response at the 12th month of therapy in axial SpA patients were female gender [odds ratio (OR) 3.23 (95% CI 1.52, 7.14)] and a BMI ≥ 30 [OR 3.57 (95% CI 1.15, 11.11)]. Analysing outcomes based on IFX therapy (the larger subgroup), the BASDAI50 response rate fell from 79.0% in normal weight subjects to 56.7% in overweight and 16.7% in obese subjects (P < 0.001). No significant differences were observed with ADA and ETA. CONCLUSION: Data suggest that being female, overweight and mostly obese is associated with a lower rate of success in obtaining response status in axial SpA patients treated with anti-TNF drugs. Body weight could represent a modifiable factor to reach the best outcome in axial SpA patients treated with TNF blockers.
OBJECTIVE: The objective of this study was to determine whether BMI and gender could lead to a different response rate to anti-TNF agents in patients affected by axial SpA. METHODS: One hundred and seventy patients with active axial SpA (defined as a BASDAI ≥ 4) treated with an anti-TNF agent [adalimumab (ADA), etanercept (ETA), infliximab (IFX)] were retrospectively evaluated. Patients were divided according to the baseline BMI as normal weight (BMI < 25), overweight (BMI 25-30) and obese (BMI ≥ 30). After 12 months of treatment a 50% improvement of the initial BASDAI (BASDAI50) was the primary end point and BASDAI ≤ 1 was the secondary end point. RESULTS: After 12 months of anti-TNF treatment, 67.8% of men and 46.2% of women reached the BASDAI50 (P = 0.01). According to BMI categories, the rate of BASDAI50 achievement decreased from 72.8% in normal weight subjects to 54.5% in overweight and 30.4% in obese subjects (P < 0.001). In the logistic regression analysis, the best independent predictors of failure to obtain a BASDAI50 response at the 12th month of therapy in axial SpA patients were female gender [odds ratio (OR) 3.23 (95% CI 1.52, 7.14)] and a BMI ≥ 30 [OR 3.57 (95% CI 1.15, 11.11)]. Analysing outcomes based on IFX therapy (the larger subgroup), the BASDAI50 response rate fell from 79.0% in normal weight subjects to 56.7% in overweight and 16.7% in obese subjects (P < 0.001). No significant differences were observed with ADA and ETA. CONCLUSION: Data suggest that being female, overweight and mostly obese is associated with a lower rate of success in obtaining response status in axial SpA patients treated with anti-TNF drugs. Body weight could represent a modifiable factor to reach the best outcome in axial SpA patients treated with TNF blockers.
Authors: José Miguel Senabre Gallego; Jose Rosas; Mariana Marco-Mingot; José Alberto García-Gómez; Gregorio Santos-Soler; Esteban Salas-Heredia; Ana Pons-Bas; Xavier Barber-Vallés; José Antonio Bernal-Vidal; Catalina Cano-Pérez; Mario García-Carrasco; Emilio Flores-Pardo Journal: Rheumatol Int Date: 2019-03-21 Impact factor: 2.631
Authors: Yi Xuan Lee; Yu Heng Kwan; Ka Keat Lim; Chuen Seng Tan; Nai Lee Lui; Jie Kie Phang; Eng Hui Chew; Truls Ostbye; Julian Thumboo; Warren Fong Journal: Singapore Med J Date: 2019-06 Impact factor: 1.858
Authors: Maria V Hernandez; Carlos Sanchez-Piedra; Blanca Garcia-Magallon; Eduardo Cuende; Javier Manero; Cristina Campos-Fernandez; Raquel Martin-Domenech; Javier Del Pino-Montes; Sara Manrique; Maria C Castro-Villegas; Dolores Ruiz-Montesinos; Fernando Sanchez-Alonso; Federico Diaz-Gonzalez; Luis Cea-Calvo; Juan J Gómez-Reino Journal: Rheumatol Int Date: 2018-10-24 Impact factor: 2.631
Authors: A Gardette; S Ottaviani; J Sellam; F Berenbaum; F Lioté; A Meyer; J Sibilia; B Fautrel; E Palazzo; P Dieudé Journal: Clin Rheumatol Date: 2016-01-22 Impact factor: 2.980