AB0434 The influence of body mass index on the efficacy of tumour necrosis factor blocking therapy and disease activity in patients with rheumatoid arthritis. (12th June 2018)

• Record Type: Journal Article
• Authors: Mole, E.N.; Zoupidou, K.; Alexoudis, A.; Koutsantoni, E.; Sfontouris, C.; Gazi, S.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1380
• Page End: 1380
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2787
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: The impact of Body Mass Index (BMI) on efficacy of TNF blocking therapy in Rheumatoid Arthritis (RA) patients and therefore on control of the disease is an important question. Objectives: The aim of this study is to determine the influence of BMI on the efficacy of TNF blocking therapy in terms of disease activity in patients with RA. Methods: A retrospective, observational study of 168 consecutive RA patients who received subcutaneously (SC) TNF blocking treatment (adalimumab, etanercept, golimumab and certolizumab pegol). Their follow-up data, for at least 26 weeks, and their baseline BMIs were available. The WHO definition for normal weight, overweight and obesity was applied, whereas clinical response was compared by BMI subgroups. Results: The average BMI was 26.83±4.34 kg/m 2 and the baseline Disease Activity Score in 28 joints (DAS28 [ESR]) was high at 5.72±0.84. Mean age was 63.47±12.58 years and 135 (80.36%) were female. The median disease duration was 13.01±8.57 years. Overall, patients with normal weight responded better to treatment regimen, followed by overweight and obese subgroups. After a follow-up period of 26 weeks, the obese group had significantly higher DAS28 (ESR) and Health Assessment Questionnaire (HAQ) than either normal or overweight subgroups (3.26±0.84 vs 2.72±0.78 vs 2.81±0.82, p<0.001, 0.423±0.002 vs 0.076±0.01 vs 0.178±0.01, p<0.001 respectively). Furthermore, obesity was significantly associated with a decreased tendency of achieving week 26 remission, based on DAS28 (<2.6) p :0.002 and normal HAQ (≤0.5) p : 0.003. Conclusions: Patients with RA and higher BMIs demonstrated a diminished clinical response after 26 weeks of SC-administered TNF-blocking treatment compared with their counterparts with lower BMIs. References: [1] Klaasen R1, et al. Body mass index and clinical response to infliximab in rheumatoid arthritis. Arthritis Rheum2011Feb;63(2):359–64. [2] Puig L1. Obesity and psoriasis: body weight and body mass index influence the response to biological treatment. J Eur Acad Dermatol Venereol2011Sep;25(9):1007–11. [3] Daïen CI1, et al. Predictive factors of response to biological disease modifying antirheumatic drugs: towards personalized medicine. Mediators Inflamm2014;2014:386148. [4] Schulman E1, et al. Overweight and Obesity Reduce the Likelihood of Achieving Sustained Remission in Early Rheumatoid Arthritis: Results from the Canadian Early Arthritis Cohort Study. Arthritis Care Res (Hoboken)2017Nov 30. Disclosure of Interest: None declared