UK researchers have found that obese rheumatoid arthritis patients are likelier to be disabled and have lower remission rates. Screening effectively for and managing weight should be central to RA management, write lead author Elena Nikiphorou, of King’s College, London, and colleagues, in research presented at the 2017 American College of Rheumatology annual meeting in San Diego.

“Higher body mass index (BMI) and in particular obesity was associated with lower remission and low disease activity states and higher disability,” they wrote. “These findings argue strongly for the screening and management of obesity to become a central part of all treatment strategies in rheumatoid arthritis.”

Obesity is a growing, global health concern, and it is understood to be a risk factor for the development of rheumatoid arthritis, according to the researchers.

“Some have suggested that in fact, obesity is a low-grade, chronic inflammatory condition,” Nikiphorou said. “In RA co-existing with obesity, both autoimmune and obesity-mediated inflammatory states may work together, affecting disease activity and consequently important disease outcomes and quality of life.”

Nikiphorou and colleagues drew upon data from two UK rheumatoid arthritis cohorts — Early RA Study (ERAS) and Early RA Network (ERAN). The median follow up time was 10 years for the 1,465 patients in ERAS, and six years for the 1,236 patients in ERAN. Among patients, more than 37 percent was overweight, and more than 21 percent was obese.

When the researchers adjusted for age, sex, and recruitment year, they found that higher body mass index tended to lower patients’ chances of achieving remission, and obesity increased their likelihood of disability by 63 percent.

“Obesity is potentially a reversible comorbidity and successfully treating it can contribute to better disease activity and functional outcomes,” Nikiphorou said.

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