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Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis

Sandberg, Maria E C LU ; Bengtsson, Camilla; Källberg, Henrik; Wesley, Annmarie; Klareskog, Lars; Alfredsson, Lars and Saevarsdottir, Saedis (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.

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author
publishing date
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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
British Medical Association
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
2017-10-16 10:44:04
@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&lt;3.2), remission (DAS28&lt;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},
  keyword      = {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    = {British Medical Association},
  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},
  volume       = {73},
  year         = {2014},
}