Excess weight worsens the prognosis of rheumatoid arthritis and disrupts its treatment

Hriana/epictura

Published the 04.12.2017 at 13h28

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polyarthritesurpoidstraitement

In a study conducted at the Weill Cornell Medical School and published in Arthritis Care & Research, a team of researchers examined data from the canadian cohort on the arthritis early, a trial observational multicenter trial involving patients with early case of rheumatoid arthritis who have been treated by rheumatologists according to the recommendations.

Impact of weight on treatment

On 982 patients, 32% had a normal BMI, 35% were overweight and 33% were obese. Over three years of follow-up, 36% of the patients had prolonged remission.
Compared to patients with a normal BMI, overweight people are 25% less likely to have a long-term remission, and those who are obese are 47% less likely to be in remission, despite similar treatments.

The overweight, a new factor of severity

This is the largest study demonstrating the negative impact of excess weight on the activity of the PR : it supports the idea that there is a need to better take into account this risk in patients. “These results have important implications for care, as rates of overweight and obesity continue to increase in our societies and among our patients,” said Dr. Goodman, one of the authors of the study.
“Our results highlight the high proportion of RA patients newly diagnosed who are overweight or obese and who may have a disease more difficult to treat. For people with RA who have not had an adequate response to the treatment, this can be another factor to consider.”

Influence of rheumatoid arthritis on mortality

In study, obesity was associated with a decreased risk of premature death; however, earlier studies had suggested that the “paradox of obesity” could be explained by unintentional weight loss in the few years preceding the death, rather than a truly protective of obesity “. A paradox confirmed by another study, Jeffrey Sparks, of the Brigham and Women’s Hospital, Harvard Medical School, and his colleagues, who have assessed the effect of the change of weight in the first few months of PR on the risk of mortality later.
Among the women with rheumatoid arthritis, 41% died during an average follow-up of 17.0 years after the early period of the PR. Among women without RA, and 29.2% died during an average follow-up of 18.4 years. In both groups, the weight at the beginning of the rheumatoid arthritis did not influence mortality.

Overweight creates problems of adjustment to the treatment of autoimmune diseases such as rheumatoid arthritis, with a risk of poor control and bad prognosis of the joint. By contrast, the excess weight in itself does not worsen the prognosis of these patients.