VIDEO: Does obesity’s effect on RA support different treatment goals?

PARIS – Treat-to-target goals for obese patients with rheumatoid arthritis should take into account new research indicating that they already have a higher level of systemic inflammation and higher Disease Activity Scores than do normal-weight patients, according to Dr. Christopher Sparks of the University of Liverpool, England.

In an international sample of 3,534 patients with rheumatoid arthritis (RA), Dr. Sparks and his colleagues found that those with a body mass index of 30-34.9 kg/m² (obese) or 35 kg/m² or greater (obese II) had higher 28-joint Disease Activity Scores (DAS28) than did normal-weight patients, a difference that was largely driven by higher erythrocyte sedimentation rates and higher Visual Analog Scale scores, rather than higher tender and swollen joint counts. The data were reported at the annual European Congress of Rheumatology.

It cannot be known whether obese patients with higher DAS28 scores have clinically more severe disease, so it leads one to wonder, "Is it just an inflated DAS28 score that’s really driving this? And so potentially it brings up the question, Is obesity a confounding factor when looking at DAS28 scores in the RA population?" Dr. Sparks said in a video interview with Dr. Christian Beyer of the University of Erlangen-Nuremberg, Germany.

"If there is an artificial rise in the DAS28 in all of our obese patients out there, should the treatment goals in terms of remission or response be potentially slightly different for obese patients, compared to normal-weight patients, because they have a baseline higher DAS28?"

jevans@frontlinemedcom.com