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Obesity linked to RA disease activity, disability

 

Key clinical point: Obesity may worsen the risk of disease activity and disability in rheumatoid arthritis.

Major finding: In an adjusted analysis, obese patients with RA were less likely to reach remission and low disease activity status (OR, 0.71; 95% CI, 0.55-0.93 and OR, 0.69; 95% CI, 0.55-0.87, respectively).

Data source: Two consecutive inception cohorts with a total of 1,236 RA patients followed for up to 25 years.

Disclosures: The lead study author reports no disclosures, and no other disclosures are reported. No specific study funding is reported.


 

AT ACR 2017

 

– In what may be the largest study of its kind, British researchers have linked obesity to significantly higher odds of rheumatoid arthritis disease activity and disability.

Dr. Elena Nikiphorou
Dr. Elena Nikiphorou
It’s not surprising that obesity and RA are linked, but the connection is more complex than may be expected. “Epidemiologic studies suggest that obesity may be associated with a modestly increased risk for the development of RA, although these studies have shown conflicting results,” wrote Michael D. George, MD, and Joshua F. Baker, MD, both of the University of Pennsylvania, Philadelphia, in a 2016 report. “Among patients with established RA, obesity has been observed to be associated with greater subjective measures of disease activity and poor treatment response, but also with a decreased risk of joint damage and lower mortality.” (Curr Rheumatol Rep. 2016 Jan;18[1]:6.)

Despite obesity having been tied to decreased joint damage in established RA, Eric L. Matteson, MD, noted in an interview, that“the biomechanical effect of [being] overweight, especially on the weight-bearing joints” is one of the two “especially important” mechanisms explaining the link between RA and obesity. “The other is that fat cells produce inflammatory proteins, which contribute to the disease process and make it more difficult to treat,” said Dr. Matteson, a rheumatologist at the Mayo Clinic, Rochester, Minn.

“In my view the mechanical risk to the joint outweighs any possible ‘protective’ effect of RA,” Dr. Matteson added in an interview.

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