OBJECTIVE: To summarize the relationship between obesity and remission in rheumatoid arthritis (RA); secondary objectives were to summarize other measures of treatment response and mortality in RA. METHODS: Medline and Embase searches were performed in March 2016 using relevant MeSH and keyword terms for obesity and RA. Articles were selected if they reported estimates for achieving remission in obese subjects relative to other body mass index (BMI) categories, or changes in composite or individual disease activity measures or patient-reported outcomes during therapy, or mortality rates, in relation to BMI category or on a continuous scale. Remission outcomes were conducive to meta-analysis, and all other outcomes were summarized. RESULTS: A total of 3,368 records were screened; we included 8 reporting remission rates, 9 reporting disease activity measures or patient-reported outcomes, and 3 examining mortality by obesity status or BMI. Obese patients attain remission less frequently than nonobese and/or normal-weight patients. In adjusted models, obese patients demonstrated lower odds of achieving remission (pooled odds ratio [OR] 0.57 [95% confidence interval (95% CI) 0.45, 0.72]) and sustained remission (pooled OR 0.49 [95% CI 0.32, 0.74]) relative to nonobese subjects. Most studies found obese patients to have worse Disease Activity Scores or Disease Activity Scores in 28 joints, tender joint counts, inflammatory markers, patient global evaluation scores, pain scores, and physical function scores during followup, but not worse swollen joint counts. Obesity was not associated with increased mortality. CONCLUSION: Obesity decreases the odds of achieving remission in RA and negatively impacts disease activity and patient-reported outcomes during therapy. Interventions to reduce BMI should be investigated for their ability to improve disease outcomes.
OBJECTIVE: To summarize the relationship between obesity and remission in rheumatoid arthritis (RA); secondary objectives were to summarize other measures of treatment response and mortality in RA. METHODS: Medline and Embase searches were performed in March 2016 using relevant MeSH and keyword terms for obesity and RA. Articles were selected if they reported estimates for achieving remission in obese subjects relative to other body mass index (BMI) categories, or changes in composite or individual disease activity measures or patient-reported outcomes during therapy, or mortality rates, in relation to BMI category or on a continuous scale. Remission outcomes were conducive to meta-analysis, and all other outcomes were summarized. RESULTS: A total of 3,368 records were screened; we included 8 reporting remission rates, 9 reporting disease activity measures or patient-reported outcomes, and 3 examining mortality by obesity status or BMI. Obesepatients attain remission less frequently than nonobese and/or normal-weight patients. In adjusted models, obesepatients demonstrated lower odds of achieving remission (pooled odds ratio [OR] 0.57 [95% confidence interval (95% CI) 0.45, 0.72]) and sustained remission (pooled OR 0.49 [95% CI 0.32, 0.74]) relative to nonobese subjects. Most studies found obesepatients to have worse Disease Activity Scores or Disease Activity Scores in 28 joints, tender joint counts, inflammatory markers, patient global evaluation scores, pain scores, and physical function scores during followup, but not worse swollen joint counts. Obesity was not associated with increased mortality. CONCLUSION:Obesity decreases the odds of achieving remission in RA and negatively impacts disease activity and patient-reported outcomes during therapy. Interventions to reduce BMI should be investigated for their ability to improve disease outcomes.
Authors: Joshua F Baker; Bryant R England; Ted R Mikuls; Harlan Sayles; Grant W Cannon; Brian C Sauer; Michael D George; Liron Caplan; Kaleb Michaud Journal: Arthritis Care Res (Hoboken) Date: 2018-12 Impact factor: 4.794
Authors: Caroline B McCulley; Jennifer L Barton; Grant W Cannon; Brian C Sauer; Chia Chen Teng; Michael D George; Liron Caplan; Bryant R England; Ted R Mikuls; Joshua F Baker Journal: Clin Exp Rheumatol Date: 2018-11-07 Impact factor: 4.473
Authors: Veena K Ranganath; Erin L Duffy; Vikram K Garg; Thasia Woodworth; Mihaela Taylor; Harold E Paulus; Roy D Altman; David A Elashoff Journal: J Clin Rheumatol Date: 2019-04 Impact factor: 3.517
Authors: Bee Eng Tan; Ai Lee Lim; Sow Lai Kan; Chong Hong Lim; Ying Fun Ng; Serene Li Ching Tng; Nur Syakirah Hassin; Losshenee Chandran; Norshahida Abdul Hamid; Yvonne Yin Leng Lee Journal: Rheumatol Int Date: 2017-04-07 Impact factor: 2.631