Longitudinal associations between body mass index and changes in disease activity and radiographic progression in rheumatoid arthritis patients treated with infliximab.

Abstract

OBJECTIVES:

Treatment response is worse in obese patients with rheumatoid arthritis (RA), including patients on weight-adjusted therapies like infliximab. We aimed to assess the association between body mass index (BMI) and changes in RA disease activity and radiographic progression over time.

METHODS:

We included infliximab users with an RA diagnosis in the Swiss Clinical Quality Management in Rheumatic Diseases registry (1997-2020). Two cohorts were defined: (1) starting from their first BMI measurement or disease activity score (DAS28-esr), and (2) from their first BMI measurement or radiographic assessment (Rau score). We evaluated the coefficient and 95% CI of BMI with changes in mean DAS28-esr (cohort 1) and mean Rau scores (a structural joint damage score, cohort 2) using generalised estimation equations, overall and stratified by BMI categories.

RESULTS:

Cohort 1 comprised 412 patients (74% women, mean age 53 years, mean BMI 25). We observed no change in mean DAS28-esr with increasing BMI overall (adjusted coefficient: 0.00, 95% CI -0.02 to 0.02), or in BMI categories. Cohort 2 comprised 187 patients highly alike to those in cohort 1. We observed a significant decrease of 1.05 in mean Rau scores for every increase in BMI unit (adjusted coefficient: -1.05, 95% CI -1.92 to -0.19). Results remained statistically non-significant across BMI categories.

CONCLUSIONS:

Our longitudinal investigation suggests that BMI increase may not lead to changes in DAS28-esr in patients receiving infliximab, despite the weight-adapted dose. Yet, there may be a decrease in erosions with increasing weight non-limited to obese patients.

• Authors: Theresa Burkard, Enriqueta Vallejo-Yagüe, Kim Lauper, Axel Finckh, Thomas Hügle, Andrea M Burden
• Journal: RMD open (RMD Open) Vol. 9 Issue 4 (10 2023) ISSN: 2056-5933 [Electronic] England
• PMID: 37802600 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

Chemical References

• Infliximab
• Antirheumatic Agents

Topics

• Humans
• Female
• Middle Aged
• Male
• Infliximab (therapeutic use)
• Body Mass Index
• Antirheumatic Agents (therapeutic use)
• Arthritis, Rheumatoid (complications, diagnostic imaging, drug therapy)
• Obesity (complications)