Rheumatoid Arthritis Remission Less Likely in Overweight Patients

Overweight and obese individuals with rheumatoid arthritis (RA) are significantly less likely to achieve sustained remission (sREM) in the first 3 years following diagnosis despite similar treatment to non-overweight patients, according to the results of a recent study.

Obesity has been shown to have an effect on RA development, severity, outcomes, and treatment response, but its effects on sREM are less well understood.
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For their study, researchers collected data from the Canadian Early Arthritis Cohort, a multicenter observational trial of 982 early rheumatoid arthritis (ERA) patients treated using guideline-based care. sREM was defined as DAS28 <2.6 for two consecutive visits.

Of the 982 patients, 315 had a healthy BMI, 343 were overweight, and 324 were obese, and 355 (36%) achieved sREM within 3 years. Compared with those with a healthy BMI, those who were overweight and obese were significantly less likely to achieve sREM (hazard ratio 0.75 and 0.53, respectively).

“Overweight patients were 25%, and obese patients were 47% less likely to achieve sREM in the first 3 years despite similar initial [disease-modifying antirheumatic drug] treatment and subsequent biologic use. This is the largest study demonstrating the negative impact of excess weight on RA disease activity and supports a call to action to better identify and address this risk in RA patients.”

—Michael Potts

Reference:

Schulman E, Bartlett SJ, Schieir O, et al. Overweight and obesity reduce the likelihood of achieving sustained remission in early rheumatoid arthritis: results from the canadian early arthritis cohort study [published online November 30, 2017]. Arth Care Res. doi: 10.1002/acr.23457.