Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis
(2014) In Annals of the Rheumatic Diseases 73(11). p.33-2029- Abstract
AIM: To investigate whether overweight/obesity at diagnosis affects the chances of decrease in disease activity and pain in early rheumatoid arthritis (RA).
METHOD: We investigated incident RA cases from the population-based Epidemiological Investigation of risk factors for Rheumatoid Arthritis (EIRA) study (2006-2009, N=495) with clinical follow-up in the Swedish Rheumatology Quality Register. At diagnosis, 93% received disease-modifying antirheumatic drugs (DMARDs) (86% methotrexate). The odds of achieving a good response according to the DAS28-based European League Against Rheumatism (EULAR) criteria, low disease activity (DAS28<3.2), remission (DAS28<2.6) or pain remission (visual analogue scale ≤20 mm) at 3-months and... (More)
AIM: To investigate whether overweight/obesity at diagnosis affects the chances of decrease in disease activity and pain in early rheumatoid arthritis (RA).
METHOD: We investigated incident RA cases from the population-based Epidemiological Investigation of risk factors for Rheumatoid Arthritis (EIRA) study (2006-2009, N=495) with clinical follow-up in the Swedish Rheumatology Quality Register. At diagnosis, 93% received disease-modifying antirheumatic drugs (DMARDs) (86% methotrexate). The odds of achieving a good response according to the DAS28-based European League Against Rheumatism (EULAR) criteria, low disease activity (DAS28<3.2), remission (DAS28<2.6) or pain remission (visual analogue scale ≤20 mm) at 3-months and 6-months follow-up, were calculated using logistic regression, adjusting for potential confounders.
RESULTS: Significant dose-response relationships were found between Body Mass Index (BMI) and change of disease activity as well as pain at both time points. Patients with BMI ≥25 had 51% lower odds of achieving low disease activity (odds ratio (OR=0.49 (95% CI 0.31 to 0.78)) and 42% lower odds of remission (OR=0.58 (95% CI 0.37 to 0.92)) at the 6-months visit, compared to normal-weight patients. This effect was also present at 3 months, where we also found a 43% decreased odds of pain remission (OR=0.57 (95% CI 0.37 to 0.88)). No effect modification was found for anti-citrullinated protein antibody (CCP)-status, sex, prednisolone treatment or DAS28 at diagnosis.
CONCLUSIONS: Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of RA.
(Less)
- author
- Sandberg, Maria E C LU ; Bengtsson, Camilla ; Källberg, Henrik ; Wesley, Annmarie ; Klareskog, Lars ; Alfredsson, Lars and Saevarsdottir, Saedis
- publishing date
- 2014-11
- type
- Contribution to journal
- publication status
- published
- keywords
- Adult, Aged, Antirheumatic Agents, Arthritis, Rheumatoid, Body Mass Index, Early Diagnosis, Female, Follow-Up Studies, Humans, Male, Methotrexate, Middle Aged, Obesity, Overweight, Pain, Pain Measurement, Prognosis, Registries, Remission Induction, Severity of Illness Index, Sweden, Treatment Outcome, Journal Article
- in
- Annals of the Rheumatic Diseases
- volume
- 73
- issue
- 11
- pages
- 5 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:84899769960
- pmid:24818635
- ISSN
- 1468-2060
- DOI
- 10.1136/annrheumdis-2013-205094
- language
- English
- LU publication?
- no
- id
- 198536e7-d91e-4c3f-9ce3-bae7bf85e65a
- date added to LUP
- 2017-10-16 08:58:31
- date last changed
- 2024-08-19 06:56:33
@article{198536e7-d91e-4c3f-9ce3-bae7bf85e65a, abstract = {{<p>AIM: To investigate whether overweight/obesity at diagnosis affects the chances of decrease in disease activity and pain in early rheumatoid arthritis (RA).</p><p>METHOD: We investigated incident RA cases from the population-based Epidemiological Investigation of risk factors for Rheumatoid Arthritis (EIRA) study (2006-2009, N=495) with clinical follow-up in the Swedish Rheumatology Quality Register. At diagnosis, 93% received disease-modifying antirheumatic drugs (DMARDs) (86% methotrexate). The odds of achieving a good response according to the DAS28-based European League Against Rheumatism (EULAR) criteria, low disease activity (DAS28<3.2), remission (DAS28<2.6) or pain remission (visual analogue scale ≤20 mm) at 3-months and 6-months follow-up, were calculated using logistic regression, adjusting for potential confounders.</p><p>RESULTS: Significant dose-response relationships were found between Body Mass Index (BMI) and change of disease activity as well as pain at both time points. Patients with BMI ≥25 had 51% lower odds of achieving low disease activity (odds ratio (OR=0.49 (95% CI 0.31 to 0.78)) and 42% lower odds of remission (OR=0.58 (95% CI 0.37 to 0.92)) at the 6-months visit, compared to normal-weight patients. This effect was also present at 3 months, where we also found a 43% decreased odds of pain remission (OR=0.57 (95% CI 0.37 to 0.88)). No effect modification was found for anti-citrullinated protein antibody (CCP)-status, sex, prednisolone treatment or DAS28 at diagnosis.</p><p>CONCLUSIONS: Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of RA.</p>}}, author = {{Sandberg, Maria E C and Bengtsson, Camilla and Källberg, Henrik and Wesley, Annmarie and Klareskog, Lars and Alfredsson, Lars and Saevarsdottir, Saedis}}, issn = {{1468-2060}}, keywords = {{Adult; Aged; Antirheumatic Agents; Arthritis, Rheumatoid; Body Mass Index; Early Diagnosis; Female; Follow-Up Studies; Humans; Male; Methotrexate; Middle Aged; Obesity; Overweight; Pain; Pain Measurement; Prognosis; Registries; Remission Induction; Severity of Illness Index; Sweden; Treatment Outcome; Journal Article}}, language = {{eng}}, number = {{11}}, pages = {{33--2029}}, publisher = {{BMJ Publishing Group}}, series = {{Annals of the Rheumatic Diseases}}, title = {{Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis}}, url = {{http://dx.doi.org/10.1136/annrheumdis-2013-205094}}, doi = {{10.1136/annrheumdis-2013-205094}}, volume = {{73}}, year = {{2014}}, }