Obesity and the prediction of minimal disease activity. A prospective study in Psoriatic Arthritis

Abstract

Objective:

We prospectively evaluated whether obesity impacts on the achieving of Minimal Disease Activity (MDA) in subjects with Psoriatic Arthritis (PsA).

Methods:

Among PsA subjects with an active disease starting a treatment with TNF-α blockers, 135 obese (Body Mass Index >30) and 135 normal-weighted patients (controls) were followed-up for 24 months. At baseline and at 12 and 24 months follow-up, all subjects underwent a clinical, rheumatologic and laboratory assessment..

Results:

With the exception for the prevalence of hypercholesterolemia and hypertriglyceridemia, case and control subjects were similar for all the clinical and demographical characteristics analyzed. At 12 months follow-up, both in cases and controls, no significant changes in the body weight was found (p always >0.05). MDA was achieved by 98/270 PsA individuals (36.3%). The prevalence of obesity was higher in those that did not achieve MDA than in those that did (64.0% vs 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%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 1^st degree (<30 BMI) and 2^nd degree (30-35 BMI) obesity, respectively. Among the 98 subjects that had achieved MDA at the 12 months follow-up, the presence of obesity was associated with a poor probability of sustained MDA at 24-months follow-up (HR:2.04, 95%CI:1.015-3.61, p=0.014).

Conclusions:

Obesity is a negative predictor of achieving and maintaining MDA. © 2012 by the American College of Rheumatology