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People with rheumatoid arthritis (RA) who are overweight or obese may be less likely than their healthy-weight peers to achieve good outcomes with RA treatment. These results were presented at the 2013 Annual European Congress of Rheumatology.

The frequency of obesity has increased sharply in recent decades, highlighting the importance of understanding how body weight affects the risk or prognosis of common chronic diseases. Among people with RA, obesity has been linked with a higher level of disease activity.

To explore how body weight affects treatment outcomes among people with early RA, researchers in Italy conducted a study among 346 patients who had been experiencing RA symptoms for less than a year. Initial RA treatment involved methotrexate, with the addition of a TNF inhibitor if the response to methotrexate was inadequate.

Based on body mass index (BMI), 49% of patients had a healthy weight, 39% were overweight, and 12% were obese.

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  • People with higher BMI tended to have greater RA disease activity and higher levels of inflammatory markers in their blood.
  • Remission was less common among heavier people. At 12-months, a remission defined by DAS criteria was achieved by 49% of healthy-weight people, 29% of overweight people, and 34% of obese people.
  • People who were overweight or obese were also more likely than healthy-weight people to have an inadequate response to methotrexate alone. Use of a TNF inhibitor was more common among the people who were overweight or obese.

These results suggest that among people with early RA, having a healthy body weight increases the likelihood of remission.

Reference: Gremese E, Fedele MR, Gigante B et al. The body mass index: a determinant of remission in early rheumatoid arthritis. Presented at the 2013 Annual European Congress of Rheumatology (EULAR 2013). June 12-15, 2013; Madrid. Abstract OP0178.