Special Theme Articles: Obesity and the Rheumatic Diseases
Obesity and the prediction of minimal disease activity: A prospective study in psoriatic arthritis
Article first published online: 27 DEC 2012
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 1, pages 141–147, January 2013
How to Cite
di Minno, M. N. D., Peluso, R., Iervolino, S., Lupoli, R., Russolillo, A., Scarpa, R. and di Minno, G. (2013), Obesity and the prediction of minimal disease activity: A prospective study in psoriatic arthritis. Arthritis Care Res, 65: 141–147. doi: 10.1002/acr.21711
- Issue published online: 27 DEC 2012
- Article first published online: 27 DEC 2012
- Accepted manuscript online: 18 APR 2012 09:40AM EST
- Manuscript Accepted: 28 AUG 2012
- Manuscript Received: 31 JAN 2012
We prospectively evaluated whether obesity impacts achievement of minimal disease activity (MDA) in subjects with psoriatic arthritis (PsA).
Among PsA subjects with an active disease and who were starting a treatment with tumor necrosis factor α blockers, 135 obese (body mass index [BMI] >30 kg/m2) patients and 135 patients of normal weight (controls) were followed up for 24 months. At baseline and at the 12- and 24-month followup, all subjects underwent a clinical, rheumatologic, and laboratory assessment.
With the exception of the prevalence of hypercholesterolemia and hypertriglyceridemia, case and control subjects were similar for all the clinical and demographic characteristics analyzed. At the 12-month followup, in both cases and controls, no significant changes in body weight were found (P > 0.05 for all). MDA was achieved by 98 (36.3%) of the 270 PsA individuals. The prevalence of obesity was higher in those that did not achieve MDA than in those that did (64.0% versus 25.5%; P < 0.001). After adjusting for all the other variables, obesity was associated with a higher risk of not achieving MDA (hazard ratio [HR] 4.90, 95% confidence interval [95% CI] 3.04–7.87; P < 0.001). The HR of not achieving MDA was 3.98 (95% CI 1.96–8.06, P < 0.001) and 5.40 (95% CI 3.09–9.43, P < 0.001) in subjects with first-degree (BMI <30 kg/m2) and second-degree (BMI 30–35 kg/m2) obesity, respectively. Among the 98 subjects who had achieved MDA at the 12-month followup, the presence of obesity was associated with a poor probability of sustained MDA at the 24-month followup (HR 2.04, 95% CI 1.015–3.61; P = 0.014).
Obesity is a negative predictor of achieving and maintaining MDA.