Obesity is a risk factor for poor response to treatment in early rheumatoid arthritis: a NORD-STAR study

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Obesity is a risk factor for poor response to treatment in early rheumatoid arthritis: a NORD-STAR study

Dubovyk, Violetta (author): Univ Gothenburg, Sweden

Vasileiadis, Georgios K. (author): Univ Gothenburg, Sweden

Fatima, Tahzeeb (author): Univ Gothenburg, Sweden

Zhang, Yuan (author): Univ Gothenburg, Sweden

Kapetanovic, Meliha Crnkic (author): Skane Univ Hosp Lund, Sweden

Kastbom, Alf (author): Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Reumatologiska kliniken i Östergötland

Rizk, Milad (author): Vastmanlands Hosp, Sweden

Soederbergh, Annika (author): Orebro Univ Hosp, Sweden

Zhao, Sizheng Steven (author): Univ Manchester, England

van Vollenhoven, Ronald F. (author): Amsterdam Rheumatol & Immunol Ctr, Netherlands; Karolinska Inst, Sweden

Hetland, Merete Lund (author): Rigshosp Glostrup, Denmark; Univ Copenhagen, Denmark

Haavardsholm, Espen A. (author): Diakonhjemmet Hosp, Norway; Univ Oslo, Norway

Nordstrom, Dan (author): Univ Helsinki, Finland

Nurmohamed, Michael T. (author): Amsterdam Rheumatol & Immunol Ctr, Netherlands; Amsterdam Rheumatol & Immunol Ctr, Netherlands

Gudbjornsson, Bjorn (author): Univ Iceland, Iceland; Landspitali Univ Hosp, Iceland

Lampa, Jon (author): Karolinska Inst, Sweden

Ostergaard, Mikkel (author): Rigshosp Glostrup, Denmark; Univ Copenhagen, Denmark

Heiberg, Marte Schrumpf (author): Diakonhjemmet Hosp, Norway

Sokka-Isler, Tuulikki (author): Univ Eastern Finland, Finland

Grondal, Gerdur (author): Univ Iceland, Iceland; Landspitali Univ Hosp, Iceland

Lend, Kristina (author): Amsterdam Rheumatol & Immunol Ctr, Netherlands; Karolinska Inst, Sweden

Horslev-Petersen, Kim (author): Univ Hosp Southern Denmark, Denmark; Univ Southern Denmark, Denmark

Uhlig, Till (author): Diakonhjemmet Hosp, Norway; Univ Oslo, Norway

Rudin, Anna (author): Univ Gothenburg, Sweden

Maglio, Cristina (author): Univ Gothenburg, Sweden

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BMJ PUBLISHING GROUP, 2024
2024
English.
In: RMD Open. - : BMJ PUBLISHING GROUP. - 2056-5933. ; 10:2

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Objective This report from the NORD-STAR (Nordic Rheumatic Diseases Strategy Trials and Registries) trial aimed to determine if obesity is associated with response to conventional and biological antirheumatic treatment in early rheumatoid arthritis (RA). Methods This report included 793 participants with untreated early RA from the randomised, longitudinal NORD-STAR trial, all of whom had their body mass index (BMI) assessed at baseline. Obesity was defined as BMI >= 30 kg/m(2). All participants were randomised 1:1:1:1 to one of four treatment arms: active conventional treatment, certolizumab-pegol, abatacept and tocilizumab. Clinical and laboratory measurements were performed at baseline and at 8, 12, 24 and 48-week follow-up. The primary endpoint for this report was response to treatment based on Clinical Disease Activity Index (CDAI) and Simple Disease Activity Index (SDAI) remission and Disease Activity Score with 28 joints using C-reactive protein (DAS28-CRP) <2.6 stratified by BMI. Results Out of 793 people included in the present report, 161 (20%) had obesity at baseline. During follow-up, participants with baseline obesity had higher disease activity compared with those with lower BMI, despite having similar disease activity at baseline. In survival analyses, obesity was associated with a lower likelihood of achieving response to treatment during follow-up for up to 48 weeks (CDAI remission, HR 0.84, 95% CI 0.67 to 1.05; SDAI, HR 0.77, 95% CI 0.62 to 0.97; DAS28-CRP <2.6, HR 0.78, 95% CI 0.64 to 0.95). The effect of obesity on response to treatment was not influenced by the treatment arms. Conclusion In people with untreated early RA followed up for up to 48 weeks, obesity was associated with a lower likelihood of good treatment response, irrespective of the type of randomised treatment received.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

Keyword

Treatment; Rheumatoid Arthritis; Risk Factors

Publication and Content Type

ref (subject category)
art (subject category)

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Rheumatology and ...

Articles in the publication: RMD Open

By the university: Linköping University

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