Obesity worsens physical function, QoL in axial spondyloarthropathy

SAN DIEGO — Patients with both obesity and axial spondyloarthropathy have higher disease activity, worse physical function and lower quality of life, according to data from a press release issued at the American College of Rheumatology Annual Meeting.

Gillian Fitzgerald, MD, rheumatology specialist registrar at St. James’s Hospital in Dublin, and colleagues set out to understand the prevalence of obesity in a cohort of patients with axial spondyloarthropathy, as well as the effect of obesity on disease outcomes among these patients.

Using data from the Ankylosing Spondylitis Registry of Ireland, which includes standardized clinical assessments for each patient, the researchers enrolled 683 patients with axial spondyloarthropathy (mean age, 45.9 years; 77% were men). They collected patient-reported data via structured interviews, as well as weight and height. BMI was calculated using WHO criteria (normal weight: <25 kg/m², overweight: 25 kg/m² to 29.9 kg/m² and obese: 30 kg/m²). Mean disease duration among patients was 19 years.

Data revealed more than half of the cohort (67.3%) was overweight or obese, with 1.1% classified as underweight; 31.6% as normal weight; 38.9% as overweight; and 28.4% as obese.

Among patients who were overweight or obese, significantly older age, longer disease history and increased comorbidities – including hypertension and hyperlipidemia – were reported compared with normal-weight patients. Additionally, higher disease activity scores, as well as worse physical function, spinal mobility and quality of life were reported among patients with obesity. However, smoking prevalence was lower among patients with obesity vs. normal-weight patients.

Patients with higher BMI and obesity also had higher scores on common measures of disease activity, physical function and quality of life, including the Bath Ankylosing Spondylitis Disease Activity Index, ASQoL, Bath Ankylosing Spondylitis Metrology Index and health assessment questionnaire, according to the press release.

“As clinicians, we are always looking for ways to reduce the burden of disease that patients carry and to improve outcomes. In this study, we demonstrated that over two-thirds of our [axial spondyloarthropathy] axSpa patients are either overweight or obese, and that these patients have more severe disease,” Fitzgerald said in the release. “Further research is needed to clarify this relationship between obesity and disease severity; in particular, the effect of losing weight on disease outcomes needs to be clarified. However, when devising treatment plans for axSpa patients, this study provides rheumatologists with a strong rationale to include strategies to actively control weight.”

Reference:
Fitzgerald G, et al. Abstract 2508. Presented at: American College of Rheumatology Annual Meeting; Nov. 3-8, 2017; San Diego.

Disclosures: Fitzgerald G. reports a relationship with AbbVie. FitzGerald O. reports relationships with AbbVie, Celgene, Bristol-Myers Squibb, Janssen, Eli Lilly, Novartis, Pfizer and UCB.