PMID- 35143117
OWN - NLM
STAT- MEDLINE
DCOM- 20221025
LR  - 20230602
IS  - 2151-4658 (Electronic)
IS  - 2151-464X (Linking)
VI  - 74
IP  - 11
DP  - 2022 Nov
TI  - Obesity and Response to Advanced Therapies in Rheumatoid Arthritis.
PG  - 1909-1916
LID - 10.1002/acr.24867 [doi]
AB  - OBJECTIVE: We performed a study of tumor necrosis factor inhibitors (TNFi) 
      compared to non-TNFi biologic therapies in rheumatoid arthritis to test whether 
      body mass index (BMI) modified the effect of each therapy. METHODS: We utilized 
      data from CorEvitas. We studied 3 clinical outcomes based on the Clinical Disease 
      Activity Index (CDAI) at 6 months from therapy initiation: 1) achievement of low 
      disease activity (LDA); 2) a change as large as the minimum clinically important 
      difference (MCID); and 3) the absolute change. We categorized BMI and utilized 
      restricted cubic splines to consider nonlinear associations. We used linear and 
      logistic regression to evaluate associations with response, adjusting for 
      confounders. To determine if comparative effectiveness of therapy varied by BMI, 
      we tested for interactions between BMI and class of therapy. RESULTS: The sample 
      included 2,891 TNFi and 3,010 non-TNFi initiators. Among all initiators, those 
      with severe obesity experienced lower odds of achieving LDA or MCID and less 
      improvement in CDAI score, although associations were attenuated with adjustment. 
      Low BMI was associated with reduced response rates in adjusted models including 
      lower odds of LDA (odds ratio 0.32 [95% confidence interval (95% CI) 0.15, 0.71], 
      P = 0.005). Analyses stratified by TNFi and non-TNFi therapies demonstrated no 
      differences in clinical response rates for TNFi versus non-TNFi across BMI 
      categories (all P for interaction >0.05). Estimates for non-TNFi biologics fit 
      within the 95% CI for TNFi. CONCLUSION: This study observed lower response rates 
      among obese and underweight patients and no evidence of a superior effect of 
      non-TNFi therapy over TNFi therapy in particular BMI categories.
CI  - (c) 2022 American College of Rheumatology. This article has been contributed to by 
      U.S. Government employees and their work is in the public domain in the USA.
FAU - Baker, Joshua F
AU  - Baker JF
AUID- ORCID: 0000-0003-0799-7563
AD  - Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia.
FAU - Reed, George
AU  - Reed G
AD  - Corrona Research Foundation, Albany, New York.
FAU - Poudel, Dilli Ram
AU  - Poudel DR
AD  - Indiana Regional Medical Center, Indiana, Pennsylvania.
FAU - Harrold, Leslie R
AU  - Harrold LR
AD  - Corrona Research Foundation, Albany, New York, and University of Massachusetts 
      Medical School, Worcester.
FAU - Kremer, Joel M
AU  - Kremer JM
AD  - Corrona Research Foundation and Albany Medical College and the Center for 
      Rheumatology, Albany, New York.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20220727
PL  - United States
TA  - Arthritis Care Res (Hoboken)
JT  - Arthritis care & research
JID - 101518086
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Tumor Necrosis Factor Inhibitors)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 0 (Biological Products)
SB  - IM
CIN - Arthritis Care Res (Hoboken). 2023 Jun;75(6):1383-1384. PMID: 36226628
MH  - Humans
MH  - *Antirheumatic Agents/therapeutic use
MH  - Tumor Necrosis Factor Inhibitors
MH  - Tumor Necrosis Factor-alpha
MH  - Treatment Outcome
MH  - *Arthritis, Rheumatoid/diagnosis/drug therapy
MH  - *Biological Products/adverse effects
MH  - Obesity/complications/diagnosis/drug therapy
EDAT- 2022/02/11 06:00
MHDA- 2022/10/26 06:00
CRDT- 2022/02/10 12:16
PHST- 2022/01/10 00:00 [revised]
PHST- 2021/11/11 00:00 [received]
PHST- 2022/02/08 00:00 [accepted]
PHST- 2022/02/11 06:00 [pubmed]
PHST- 2022/10/26 06:00 [medline]
PHST- 2022/02/10 12:16 [entrez]
AID - 10.1002/acr.24867 [doi]
PST - ppublish
SO  - Arthritis Care Res (Hoboken). 2022 Nov;74(11):1909-1916. doi: 10.1002/acr.24867. 
      Epub 2022 Jul 27.