Aim:
To investigate the impact of body mass index (BMI) on clinical disease activity
indices and clinical and sonographic remission rates in patients with rheumatoid arthritis (RA).
Patients and Methods:
Sixty-three patients with RA were categorized according to BMI score into
three groups: normal (BMI<25), overweight (BMI 25-30) and obese (BMI≥30). Thirty-three of
them were treated with conventional synthetic disease-modifying anti-rheumatic drugs
(csDMARDs), and 30 with biologic DMARDs (bDMARDs). Patients underwent clinical and laboratory
assessment and musculoskeletal ultrasound examination (MSUS) at baseline and at 6 months
after initiation of therapy. We evaluated the rate of clinical and sonographic remission (defined as
Power Doppler score (PD) = 0) and its correlation with BMI score.
Results:
In the csDMARDs group, 60% of the normal weight patients reached DAS28 remission;
33.3% of the overweight; and 0% of the obese patients. In the bDMARDs group, the percentage of
remission was as follows: 60% in the normal weight subgroup, 33.3% in the overweight; and
15.8% in the obese. Within the csDMARDs treatment group, two significant correlations were
found: BMI score–DAS 28 at 6th month, rs = .372, p = .033; BMI score–DAS 28 categories, rs =
.447, p = .014. Within the bDMARDs group, three significant correlations were identified: BMI
score–PDUS at sixth month, rs = .506, p =.004; BMI score–DAS 28, rs = .511, p = .004; BMI
score–DAS 28 categories, rs = .592, p = .001. Sonographic remission rates at 6 months were significantly
higher in the normal BMI category in both treatment groups.
Conclusion:
BMI influences the treatment response, clinical disease activity indices and the rates
of clinical and sonographic remission in patients with RA. Obesity and overweight are associated
with lower remission rates regardless of the type of treatment.
Smoking, body mass index, disease activity, and the risk of rapid radiographic progression in patients with early rheumatoid arthritis