Elena Nikiphorou1,2, Sam Norton1, Adam Young3, Josh Dixey4, David Walsh5, Henrietta Helliwell1, Patrick Kiely6. 1. Academic Rheumatology Department, King's College London, UK. 2. Rheumatology, Whittington Hospital NHS Trust, London, UK. 3. Centre for Lifespan & Chronic Illness Research, University of Hertfordshire, Hatfield, UK. 4. Department of Rheumatology, New Cross Hospital, Wolverhampton, UK. 5. Arthritis UK Pain Centre, University of Nottingham, Nottingham, UK. 6. Department of Rheumatology, St Georges University Hospitals NHS Foundation Trust, London, UK.
Abstract
OBJECTIVES: To examine associations between BMI and disease activity, functional ability and quality of life in RA. METHODS: Data from two consecutive, similarly designed UK multicentre RA inception cohorts were used: the Early RA Study (ERAS) and the Early RA Network (ERAN). Recruitment figures/median follow-up for the ERAS and ERAN were 1465/10 years (maximum 25 years), and 1236/6 years (maximum 10 years), respectively. Standard demographic and clinical variables were recorded at baseline and annually. Multilevel piecewise longitudinal models with a change point at 2 years were used with the 28-joint DAS (DAS28), ESR, HAQ and 36-item Short Form Health Survey (SF-36) physical (PCS) and mental (MCS) components as dependent variables. BMI was examined in separate models as both continuous and categorical variables (based on World Health Organization definitions) and up to 5 years from disease onset. RESULTS: BMI data from 2386 newly diagnosed RA patients (11 348 measures) showed an increase in BMI of 0.27 U annually (95% CI 0.21, 0.33). Baseline obesity was associated with a significant reduction in the odds of achieving a low year 2 DAS28 [OR 0.52 (95% CI 0.41, 0.650)]. At year 2, HAQ and SF-36 PCS scores were significantly worse but not at year 5 in patients obese at baseline. Obesity at year 2 was associated with higher DAS28 scores at year 2, but not at year 5, and also associated with significantly higher HAQ and SF-36 PCS scores at years 2 and 5. CONCLUSION: Obesity prevalence is rising in early RA and associates with worse disease activity, function and health-related quality of life, with a significant negative impact on achieving a low DAS28. The data argue strongly for obesity management to become central to treatment strategies in RA.
OBJECTIVES: To examine associations between BMI and disease activity, functional ability and quality of life in RA. METHODS: Data from two consecutive, similarly designed UK multicentre RA inception cohorts were used: the Early RA Study (ERAS) and the Early RA Network (ERAN). Recruitment figures/median follow-up for the ERAS and ERAN were 1465/10 years (maximum 25 years), and 1236/6 years (maximum 10 years), respectively. Standard demographic and clinical variables were recorded at baseline and annually. Multilevel piecewise longitudinal models with a change point at 2 years were used with the 28-joint DAS (DAS28), ESR, HAQ and 36-item Short Form Health Survey (SF-36) physical (PCS) and mental (MCS) components as dependent variables. BMI was examined in separate models as both continuous and categorical variables (based on World Health Organization definitions) and up to 5 years from disease onset. RESULTS: BMI data from 2386 newly diagnosed RA patients (11 348 measures) showed an increase in BMI of 0.27 U annually (95% CI 0.21, 0.33). Baseline obesity was associated with a significant reduction in the odds of achieving a low year 2 DAS28 [OR 0.52 (95% CI 0.41, 0.650)]. At year 2, HAQ and SF-36 PCS scores were significantly worse but not at year 5 in patientsobese at baseline. Obesity at year 2 was associated with higher DAS28 scores at year 2, but not at year 5, and also associated with significantly higher HAQ and SF-36 PCS scores at years 2 and 5. CONCLUSION:Obesity prevalence is rising in early RA and associates with worse disease activity, function and health-related quality of life, with a significant negative impact on achieving a low DAS28. The data argue strongly for obesity management to become central to treatment strategies in RA.
Authors: George S Metsios; R H Moe; M van der Esch; J J C S Veldhuijzen van Zanten; S A M Fenton; Y Koutedakis; P Vitalis; N Kennedy; N Brodin; C Bostrom; T W Swinnen; K Tzika; K Niedermann; E Nikiphorou; G E Fragoulis; T P V M Vlieland; C H M Van den Ende; George D Kitas Journal: Rheumatol Int Date: 2019-12-04 Impact factor: 2.631
Authors: Barbara Tolusso; Maria Rita Gigante; Stefano Alivernini; Luca Petricca; Anna Laura Fedele; Clara Di Mario; Barbara Aquilanti; Maria Rosaria Magurano; Gianfranco Ferraccioli; Elisa Gremese Journal: Front Med (Lausanne) Date: 2018-08-03
Authors: Stefano Alivernini; Barbara Tolusso; Maria Rita Gigante; Luca Petricca; Laura Bui; Anna Laura Fedele; Clara Di Mario; Roberta Benvenuto; Francesco Federico; Gianfranco Ferraccioli; Elisa Gremese Journal: Sci Rep Date: 2019-07-18 Impact factor: 4.379
Authors: Elena Nikiphorou; Sam J Norton; Lewis Carpenter; David A Walsh; Paul Creamer; Josh Dixey; Adam Young; Patrick D W Kiely Journal: Rheumatology (Oxford) Date: 2020-06-01 Impact factor: 7.580