TY - JOUR
T1 - Obesity is a risk factor for poor response to treatment in early rheumatoid arthritis
T2 - a NORD-STAR study
AU - Dubovyk, Violetta
AU - Vasileiadis, Georgios K
AU - Fatima, Tahzeeb
AU - Zhang, Yuan
AU - Kapetanovic, Meliha Crnkic
AU - Kastbom, Alf
AU - Rizk, Milad
AU - Söderbergh, Annika
AU - Zhao, Sizheng Steven
AU - van Vollenhoven, Ronald F
AU - Hetland, Merete Lund
AU - Haavardsholm, Espen A
AU - Nordström, Dan
AU - Nurmohamed, Michael T
AU - Gudbjornsson, Bjorn
AU - Lampa, Jon
AU - Østergaard, Mikkel
AU - Heiberg, Marte Schrumpf
AU - Sokka-Isler, Tuulikki
AU - Gröndal, Gerdur
AU - Lend, Kristina
AU - Hørslev-Petersen, Kim
AU - Uhlig, Till
AU - Rudin, Anna
AU - Maglio, Cristina
N1 - © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.
PY - 2024/4/4
Y1 - 2024/4/4
N2 - OBJECTIVE: This report from the NORD-STAR (Nordic Rheumatic Diseases Strategy Trials and Registries) trial aimed to determine if obesity is associated with response to conventional and biological antirheumatic treatment in early rheumatoid arthritis (RA).METHODS: This report included 793 participants with untreated early RA from the randomised, longitudinal NORD-STAR trial, all of whom had their body mass index (BMI) assessed at baseline. Obesity was defined as BMI ≥30 kg/m2. All participants were randomised 1:1:1:1 to one of four treatment arms: active conventional treatment, certolizumab-pegol, abatacept and tocilizumab. Clinical and laboratory measurements were performed at baseline and at 8, 12, 24 and 48-week follow-up. The primary endpoint for this report was response to treatment based on Clinical Disease Activity Index (CDAI) and Simple Disease Activity Index (SDAI) remission and Disease Activity Score with 28 joints using C-reactive protein (DAS28-CRP) <2.6 stratified by BMI.RESULTS: Out of 793 people included in the present report, 161 (20%) had obesity at baseline. During follow-up, participants with baseline obesity had higher disease activity compared with those with lower BMI, despite having similar disease activity at baseline. In survival analyses, obesity was associated with a lower likelihood of achieving response to treatment during follow-up for up to 48 weeks (CDAI remission, HR 0.84, 95% CI 0.67 to 1.05; SDAI, HR 0.77, 95% CI 0.62 to 0.97; DAS28-CRP <2.6, HR 0.78, 95% CI 0.64 to 0.95). The effect of obesity on response to treatment was not influenced by the treatment arms.CONCLUSION: In people with untreated early RA followed up for up to 48 weeks, obesity was associated with a lower likelihood of good treatment response, irrespective of the type of randomised treatment received.TRIAL REGISTRATION NUMBER: NCT01491815.
AB - OBJECTIVE: This report from the NORD-STAR (Nordic Rheumatic Diseases Strategy Trials and Registries) trial aimed to determine if obesity is associated with response to conventional and biological antirheumatic treatment in early rheumatoid arthritis (RA).METHODS: This report included 793 participants with untreated early RA from the randomised, longitudinal NORD-STAR trial, all of whom had their body mass index (BMI) assessed at baseline. Obesity was defined as BMI ≥30 kg/m2. All participants were randomised 1:1:1:1 to one of four treatment arms: active conventional treatment, certolizumab-pegol, abatacept and tocilizumab. Clinical and laboratory measurements were performed at baseline and at 8, 12, 24 and 48-week follow-up. The primary endpoint for this report was response to treatment based on Clinical Disease Activity Index (CDAI) and Simple Disease Activity Index (SDAI) remission and Disease Activity Score with 28 joints using C-reactive protein (DAS28-CRP) <2.6 stratified by BMI.RESULTS: Out of 793 people included in the present report, 161 (20%) had obesity at baseline. During follow-up, participants with baseline obesity had higher disease activity compared with those with lower BMI, despite having similar disease activity at baseline. In survival analyses, obesity was associated with a lower likelihood of achieving response to treatment during follow-up for up to 48 weeks (CDAI remission, HR 0.84, 95% CI 0.67 to 1.05; SDAI, HR 0.77, 95% CI 0.62 to 0.97; DAS28-CRP <2.6, HR 0.78, 95% CI 0.64 to 0.95). The effect of obesity on response to treatment was not influenced by the treatment arms.CONCLUSION: In people with untreated early RA followed up for up to 48 weeks, obesity was associated with a lower likelihood of good treatment response, irrespective of the type of randomised treatment received.TRIAL REGISTRATION NUMBER: NCT01491815.
KW - Humans
KW - Methotrexate/therapeutic use
KW - Treatment Outcome
KW - Arthritis, Rheumatoid/complications
KW - Risk Factors
KW - Obesity/complications
KW - C-Reactive Protein
UR - http://www.scopus.com/inward/record.url?scp=85190333529&partnerID=8YFLogxK
U2 - 10.1136/rmdopen-2024-004227
DO - 10.1136/rmdopen-2024-004227
M3 - Journal article
C2 - 38580350
SN - 2056-5933
VL - 10
JO - RMD Open
JF - RMD Open
IS - 2
M1 - e004227
ER -