Comorbid Obesity big hurdle for achieving remission among patients with psoriatic arthritis
Obesity is more prevalent in psoriatic arthritis (PsA) patients. According to a recent study published in Rheumatic and Musculoskeletal Diseases, Patients with PsA and comorbid obesity are 2.5 – 3 folds less likely to be in remission or low disease activity (LDA) by composite scores. Comorbid obesity requires personalized management, they added.
Moreover, reducing body weight may enhance the likelihood of achieving remission among individuals commencing biological therapeutic interventions. Nonetheless, there exists limited knowledge regarding the impact of obesity on attaining remission or low disease activity (LDA) when employing clinical indices and accounting for patient perspectives.
Baseline data from Remission/Flare in PsA, an international multi-centre cohort study, evaluated adult patients with PsA from 14 countries. The PsA duration was≥2 years. Researchers obtained information on demographics, comorbidities, clinical data, and patient-reported outcomes.
Obesity was defined as a BMI of ≥30 kg/m2. Remission or LDA was categorized as Very Low Disease Activity (VLDA), minimal disease activity (MDA), Disease Activity in Psoriatic Arthritis (DAPSA) ≤4/≤14, or by the patient’s opinion. Adjustments in multivariable regression models were made to determine the link between obesity and the presence of either remission or LDA.
Key points of the study are:
- Out of 431 patients included in the study, 136, constituting 31.6 %, had obesity.
- Compared to nonobese patients, researchers found female predilection among obese patients. There was worse pain and physical function with impaired life quality. These patients also experience higher tender joint and enthesitis counts.
- Patients with obesity were less likely to be in VLDA, DAPSA remission, and MDA with adjusted odds ratios of .31, .39 and .61, respectively.
- There were similarities between the rates of DAPSA-LDA and patient-reported remission and LDA among obese and nonobese patients.
Study limitations include small sample size, hindered generalizability of the results, lack of evaluation of changes in remission status or casualty, and discrepancies.
Psoriatic arthritis patients with concurrent obesity had lower odds of remission by indices. The study highlights the importance of managing obesity in improving the care of such patients.
Further reading:
Leung YY, Eder L, Orbai AM, Coates LC, de Wit M, Smolen JS, Kiltz U, Palominos P, Canete JD, Scrivo R, Balanescu A, Dernis E, Meisalu S, Soubrier M, Kalyoncu U, Gossec L. Association between obesity and likelihood of remission or low disease activity status in psoriatic arthritis applying index-based and patient-based definitions of remission: a cross-sectional study. RMD Open. 2023 Sep;9(3):e003157. doi: 10.1136/rmdopen-2023-003157. PMID: 37709527; PMCID: PMC10503343.
