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BMI impacted chance of sustained remission for overweight and underweight RA patients

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Researchers from the Hospital for Special Surgery found that patients with rheumatoid arthritis who have a significantly high or low body mass index are less likely to achieve sustained remission, according to a recent presentation at the American College of Rheumatology meeting.

“What’s striking is that if you look at the BMI classifications, all the patients in the underweight or overweight categories were much less likely to achieve sustained remission compared to those with a normal BMI,” study author, Susan Goodman, MD, said in a press release. “Patients who were severely obese had an even lower chance of achieving sustained remission. Individuals in the highest BMI categories also had more inflammation and more pain.”

Goodman and colleagues prospectively followed 944 patients with rheumatoid arthritis (RA) in the Canadian Early Arthritis Cohort study during a 3-year period to evaluate whether body mass index (BMI) contributed to sustained remission. They used the Disease Activity Score for RA (DAS28) to determine whether patients had achieved sustained remission, which was defined as having a low DAS28 score at two consecutive physician visits between 3 months and 12 months apart.

Susan Goodman

The researchers found patients who had a BMI below 18.5 or above 25 were significantly less likely to achieve sustained remission. Specifically, patients with a BMI above 35 were the least likely to achieve sustained remission when compared with patients who had a normal BMI.

Goodman and colleagues also found that other factors not related to BMI, such as responding to treatment during the first 6 months, not smoking and use of methotrexate, were linked to an increased likelihood of sustained remission.

“Our findings represent the first study to present evidence that BMI should be considered among the modifiable risk factors for poor RA outcomes,” Goodman said. “There are many things patients can do to manage the disease. Along with timely diagnosis and treatment, weight control and other good practices can result in better outcomes.”

Reference:

Goodman SM. Paper #394. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.