No predictive effect of body mass index on clinical response in patients with rheumatoid arthritis after 24 weeks of biological disease-modifying antirheumatic drugs: a single-center study

Clinical Rheumatology - Tập 35 - Trang 1129-1136 - 2016
Seong-Kyu Kim1, Jung-Yoon Choe1, Sung-Hoon Park1, Hwajeong Lee1
1Division of Rheumatology, Department of Internal Medicine, Arthritis and Autoimmunity Research Center, School of Medicine, Catholic University of Daegu, Nam-gu, Republic of Korea

Tóm tắt

The aim of this study was to determine whether body mass index (BMI) is associated with clinical response to biologics in patients with rheumatoid arthritis (RA). We enrolled 68 patients with RA who were treated with biological disease-modifying antirheumatic drugs (bDMARDs). Biologics included abatacept, tocilizumab, and tumor necrosis factor-α (TNF-α) blockers (etanercept and adalimumab). Baseline BMI (kg/m2) was classified as normal (BMI < 23.0), overweight (23.0 ≤ BMI < 25.0), or obese (BMI ≥ 25.0). Improvement of disease activity score 28 (DAS28) and achievement of the European League Against Rheumatism (EULAR) remission and responses between baseline and 24 weeks were our measures of clinical improvement. Mean baseline BMI before treatment with bDMARDs in patients with RA was 22.2 (SD 3.6). DAS28-ESR and DAS28-CRP were significantly reduced from baseline after 24 weeks of treatment with bDMARDs (p < 0.001 of both). ∆DAS28-ESR and ∆DAS28-CRP were not found among patients with normal, overweight, or obese BMI (p = 0.133 and p = 0.255, respectively) nor were EULAR responses or EULAR remission (p = 0.540 and p = 0.957, respectively). Logistic regression analysis showed no relationship of BMI with EULAR clinical responses (p = 0.093 for good response and p = 0.878 for EULAR remission). This study reveals that BMI is not a predictive factor of clinical response to bDMARDs in patients with RA.

Tài liệu tham khảo

Bray GA, Bellanger T (2006) Epidemiology, trends, and morbidities of obesity and the metabolic syndrome. Endocrine 29:109–117 Lago F, Dieguez C, Gómez-Reino J et al (2007) Adipokines as emerging mediators of immune response and inflammation. Nat Clin Pract Rheumatol 3:716–724 Abella V, Scotece M, Conde J et al (2014) Adipokines, metabolic syndrome and rheumatic diseases. J Immunol Res 2014:343746 Ajeganova S, Andersson ML, Hafström I; BARFOT Study Group (2013) Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: a long-term followup from disease onset. Arthritis Care Res (Hoboken) 65:78–87 Sandberg ME, Bengtsson C, Källberg H et al (2014) Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis. Ann Rheum Dis 73:2029–2033 Durcan L, Wilson F, Conway R et al (2012) Increased body mass index in ankylosing spondylitis is associated with greater burden of symptoms and poor perceptions of the benefits of exercise. J Rheumatol 39:2310–2314 Klaasen R, Wijbrandts CA, Gerlag DM et al (2011) Body mass index and clinical response to infliximab in rheumatoid arthritis. Arthritis Rheum 63:359–364 Gremese E, Carletto A, Padovan M et al (2013) Obesity and reduction of the response rate to anti-tumor necrosis factor alpha in rheumatoid arthritis: an approach to personalized medicine. Arthritis Care Res 65:94–100 Ottaviani S, Gardette A, Tubach F et al (2015) Body mass index and response to infliximab in rheumatoid arthritis. Clin Exp Rheumatol 33:478–483 Pers YM, Godfrin-Valnet M, Lambert J et al (2015) Response to tocilizumab in rheumatoid arthritis is not influenced by the body mass index of the patient. J Rheumatol 42:580–584 Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324 Prevoo MLL, van’t Hof MA, Kuper HH et al (1995) Modified disease activity scores that include twenty-eight-joint counts: development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48 van Gestel AM, Prevoo ML, van’t Hof MA et al (1996) Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis: comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism criteria. Arthritis Rheum 39:34–40 Shiwaku K, Anuurad E, Enkhmaa B et al (2004) Overweight Japanese with body mass indexes of 23.0–24.9 have higher risks for obesity-associated disorders: a comparison of Japanese and Mongolians. Int J Obes 28:152–158 Steering Committee (2000) The Asia-Pacific perspective: redefining obesity and its treatment. International Diabetes Institute, Melbourne Rendas-Baum R, Wallenstein GV, Koncz T et al (2011) Evaluating the efficacy of sequential biologic therapies for rheumatoid arthritis patients with an inadequate response to tumor necrosis factor-α inhibitors. Arthritis Res Ther 13:R25 Daïen CI, Morel J (2014) Predictive factors of response to biological disease modifying antirheumatic drugs: towards personalized medicine. Mediators Inflamm 2014:386148 Stavropoulos-Kalinoglou A, Metsios GS, Koutedakis Y et al (2011) Obesity in rheumatoid arthritis. Rheumatology (Oxford) 50:450–462 Heimans L, van den Broek M, le Cessie S et al (2013) Association of high body mass index with decreased treatment response to combination therapy in recent-onset rheumatoid arthritis patients. Arthritis Care Res (Hoboken) 65:1235–1242 Stavropoulos-Kalinoglou A, Metsios GS, Panoulas VF et al (2009) Underweight and obese states both associate with worse disease activity and physical function in patients with established rheumatoid arthritis. Clin Rheumatol 28:439–444 Jawaheer D, Olsen J, Lahiff M et al (2010) Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study. Clin Exp Rheumatol 28:454–461 Choy EH, Isenberg DA, Garrood T et al (2002) Therapeutic benefit of blocking interleukin-6 activity with an anti–interleukin-6 receptor monoclonal antibody in rheumatoid arthritis: a randomized, double-blind, placebo-controlled, dose-escalation trial. Arthritis Rheum 46:3143–3150 Wallenius V, Wallenius K, Ahrén B et al (2002) Interleukin-6-deficient mice develop mature-onset obesity. Nat Med 8:75–79 Younis S, Rosner I, Rimar D et al (2013) Weight change during pharmacological blockade of interleukin-6 or tumor necrosis factor-α in patients with inflammatory rheumatic disorders: a 16-week comparative study. Cytokine 61:353–355 Iannone F, Finckh A, Neto D et al (2014) Body mass doses not affect clinical outcomes of therapy with abatacept with in rheumatoid arthritis patients. A Pan-European Analysis of RA Registries. Ann Rheum Dis 73(Suppl2):498–499 Nüßlein H, Alten R, Galeazzi M et al (2015) Does body mass index impact long-term retention with abatacept in patients with rheumatoid arthritis who have received at least one prior biologic agent? 2-year results from a real-world, international, prospective study. Rheumatology 54(suppl 1):i186–i187 Fujii M, Inoguchi T, Batchuluun B et al (2013) CTLA-4Ig immunotherapy of obesity-induced insulin resistance by manipulation of macrophage polarization in adipose tissues. Biochem Biophys Res Commun 438:103–109 Ursini F, Russo E, Letizia Hribal M et al (2015) Abatacept improves whole-body insulin sensitivity in rheumatoid arthritis: an observational study. Medicine (Baltimore) 94, e888 Kim DM, Ahn CW, Nam SY (2005) Prevalence of obesity in Korea. Obes Rev 6:117–121 Park HS, Park CY, Oh SW et al (2008) Prevalence of obesity and metabolic syndrome in Korean adults. Obes Rev 9:104–107