Obesity and Rheumatoid arthritis: is disease progression worse and does adalimumab improve symptoms?

This study investigated if the response to rheumatoid arthritis (RA) treatment is worse in obese patients. They found that obese patients with RA have a worse clinical response than non-obese patients do.

Rheumatoid arthritis (RA) is an inflammatory condition. Fat tissue contains high levels of inflammatory chemicals. Therefore, obesity may contribute to RA symptoms.

Disease activity may be higher in obese patients. They may also experience more pain and joint damage than non-obese RA patients. Methotrexate (MTX) is one of the most common drugs prescribed for patients with RA. However, some patients respond poorly to this treatment. These patients may benefit from other drugs, such as adalimumab (ADA; Humira). It is unclear if obesity negatively affects treatment response in patients with RA.

This study included 308 patients with RA with a poor response to MTX treatment. All patients received adalimumab (ADA) with MTX in either low-dose (7.5 milligrams/week) or high-dose (20 milligrams/week). This analysis investigated if the response to these medications was different in obese and non-obese patients. Patients were classified as normal weight (69 patients), overweight (102 patients) or obese (137 patients). The study lasted 24 weeks.

Disease activity was less likely to improve in obese patients compared to the other two groups. Quality of life and physical function scores were lower in obese patients. This was true especially for patients on low-dose MTX. By week 24, ADA and MTX improved disease activity in obese patients. Obese patients saw a smaller improvement in disease activity than other patients.

The authors concluded that obese patients with RA have a worse clinical response to treatment than non-obese patients do. They suggested that these patients may benefit from ADA treatment with MTX in doses higher than 7.5 milligrams/week.

These patients had established RA. The effect of obesity on treatment response may be different in early RA.

If you have any questions regarding rheumatoid arthritis treatment, please discuss this with your physician.