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Body mass index and response to infliximab in rheumatoid arthritis

1, 2, 3, 4, 5, 6, 7, 8

 

  1. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
  2. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
  3. Département d’Epidémiologie Biostatistique et Recherche Clinique, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  4. Département d’Epidémiologie Biostatistique et Recherche Clinique, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  5. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
  6. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
  7. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
  8. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.

CER8089
2015 Vol.33, N°4
PI 0478, PF 0483
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PMID: 25962513 [PubMed]

Received: 03/11/2014
Accepted : 10/02/2015
In Press: 11/05/2015
Published: 20/07/2015

Abstract

OBJECTIVES:
Excess adipose tissue in obese individuals may have immunomodulating properties and pharmacokinetics consequences. Previous studies have suggested that obesity could negatively affect the response to anti-TNF-α agents, notably infliximab (IFX). We aimed to determine whether body mass index (BMI) is involved in the response to IFX in rheumatoid arthritis (RA).
METHODS:
We retrospectively examined data for 76 RA patients receiving IFX. BMI was calculated before treatment, and change from baseline in DAS28, pain on a visual analog scale, erythrocyte sedimentation rate, C-reactive protein level, tender and swollen joint count was analysed at 6 months after treatment. The primary outcome was decrease in DAS28 ≥1.2. Secondary outcomes were good response and remission according to EULAR.
RESULTS:
At baseline, the median [interquartile range] BMI was 26.6 [22.6–30.6] kg/m2. The number of patients with normal weight, overweight and obesity was 25, 29 and 22. In multivariable analyses, IFX treated patients with lower BMI showed a more frequent DAS28 decrease ≥1.2 (25.5 [22.3–28.3] vs. 28.0 [23.2–32.5], p=0.02, odds ratio [OR] 0.88 [95% confidence interval 0.79–0.98]), EULAR good response (25.3 [21.9–27.5] vs. 27.5 [24.3–31.2], p=0.03, OR 0.87 [0.76–0.99]) and EULAR remission, although not significant (25.3 [21.9–26.4] vs. 27.5 [23.2–30.9], p=0.14, OR 0.88 [0.75–1.04]).
CONCLUSIONS:
Obesity may negatively influence the response to IFX in RA. These data could help physicians to choose biologic agents for obese RA patients.

Rheumatology Article