Impact of obesity on therapeutic response
| Disease | Drug studied | Patients (n) | Results |
|---|---|---|---|
| RA | cDMARD | 495 | Likelihood in overweight patients compared to normal-weight patients of achieving at 6 months LDAS: OR=0.49 (95% CI 0.31 to 0.78) and remission: OR=0.58 (0.37 to 0.92)38 |
| RA | cDMARD and infliximab | 508 | Likelihood in overweight patients compared to normal-weight patients of not achieving at 1 year DAS <2.4: RR=1.20 (1.05 to 1.37)31 |
| RA | Infliximab | 89 | Percentage of responders (DAS28 ≥1.2): 50% for patients with obesity, 75% for those with BMI 20–30 kg/m2 and 84% for those with BMI <20 kg/m2 (p=0.04)39 |
| RA | TNFi | 641 | DAS28 remission at 12 months less frequent in patients with obesity: 15.2% in patients with obesity, 30.4% in overweight patients and 32.9% in patients with a BMI <25 kg/m2, the difference being only significant in IFX treated patients (not in ADA or ETN)40 |
| RA | Tocilizumab | 222 | Likelihood in patients with obesity compared to normal-weight patients of achieving at 6 months EULAR response: OR 1.19, 95% CI 0.31 to 4.48, p=0.7841 |
| AS | Infliximab | 155 | Lower BASDAI50 therapeutic response at 6 months in patients with obesity (26.5%) than in normal-weight (77.6%) individuals42 |
| AS | TNFi | 170 | Likelihood of achieving BASDAI50 at 12 months in patients with obesity compared to normal-weight participants: OR=3.57 (1.15 to 11.11), the difference being only significant in IFX treated patients (not in ADA or ETN)43 |
| PsA | TNFi | 270 | Likelihood of not achieving MDA in patients with obesity: HR=4.90 (3.04 to 7.87; p<0.001), and in morbidly patients with obesity: HR=5.40 (3.09 to 9.43, p<0.001), with no difference between the 3 TNFi36 |
| PsA | cDMARD and TNFi | 557 | Likelihood of achieving MDA in patients with obesity: OR 0.53; p<0.000137 |
ADA, adalimumab; AS, ankylosing spondylitis; BASDAI, Bath ankylosing spondylitis disease activity index; BMI, body mass index; cDMARD, conventional disease-modifying antirheumatic drug; DAS, disease activity score; ETN, etanercept; EULAR, European League Against Rheumatism; IFX, infliximab; LDAS, low disease activity score; MDA, minimal disease activity; PsA, psoriatic arthritis; RA, rheumatoid arthritis; TNFi: tumour necrosis factor inhibitor.