New research has offered insight into the potential effects of weight on the health of patients with rheumatoid arthritis (RA).1 A study published in Arthritis Care & Research sought to examine how overweight and obesity may affect a person’s likelihood of achieving remission in early RA.2 Another study, published in Arthritis & Rheumatology, explored weight change in patients with early RA and their subsequent risk for early death.3

According to research, weight may influence the efficacy of certain RA therapies. Susan Goodman, MD, and colleagues from the Hospital for Special Surgery and Weill Cornell Medical School in New York City investigated the potential effect of weight on a patient’s likelihood of achieving remission early in the course of a diagnosis of RA.2 Data from the Canadian Early Arthritis Cohort (CATCH) Study, a multicenter, observational trial of patients with early RA who received treatment from rheumatologists using guideline-based care, were evaluated.

“Our study looks at people with recently diagnosed, early RA, who should have the best outcomes and best responses to treatment, and sees how many are either overweight or obese, and then determines if those who are overweight or obese have worse outcomes than those with healthy weight,” explained Dr Goodman in a news release.1


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Of 982 patients evaluated, 32% had a healthy body mass index (BMI), 35% were overweight, and 33% were obese. Within 3 years, 36% of patients experienced sustained remission. When compared with individuals with a healthy BMI, overweight patients were 25% less likely and obese patients were 47% less likely to experience sustained remission, even though they had received similar treatments.2

This research represents the largest study to date to show the deleterious effects of excessive weight on disease activity in patients with RA, supporting a call to action to better recognize and address such a risk in this population.

Other studies have found obesity to be associated with a decreased risk for early death in patients with RA. Follow-up studies attempt to explain this “obesity paradox” by suggesting that it is a result of unexplained weight loss in the few years before death, rather than being an actual protective effect of obesity. In other words, patients with RA of long duration who achieved normal or underweight BMI have higher rates of mortality and are relatively less healthy than patients with RA who maintained obesity or being overweight.

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Jeffrey Sparks, MD, MMSc, and colleagues from Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, evaluated the effect of weight change in patients with early RA on subsequent risk for mortality.3 Their study, published in Arthritis & Rheumatology, included 902 women diagnosed with RA from the Nurses’ Health Study and 7884 matched control patients.3 The investigators reported that women with RA had higher mortality rates compared with those without RA.

The findings from both of these studies offer new insight into the possible association between increased weight and poor health among patients with RA. Additional research is warranted to further investigate this possible link.

References

  1. Studies examine the effects of weight on patients with rheumatoid arthritis [news release]. Hoboken, NJ: Wiley Publishing. http://newsroom.wiley.com/press-release/arthritis-care-research/studies-examine-effects-weight-patients-rheumatoid-arthritis. November 28, 2017. Accessed November 30, 2017.
  2. Schulman E, Bartlett SJ, Schieir O, et al; for the CATCH Investigators. Overweight and obesity reduce the likelihood of achieving sustained remission in early rheumatoid arthritis: results from the Canadian Early Arthritis Cohort study [published online November 30, 2017]. Arthritis Care Res. doi:10.1002/acr.23457
  3. Sparks JA, Chang S-C, Nguyen U-S, et al. Weight change in the early rheumatoid arthritis period and risk for subsequent mortality among women with RA and matched comparators [published online December 7, 2017]. Arthritis Rheum. doi:10.1002/art.40346