The results of a study presented today at the European Congress of Annual Rheumatology (EULAR 2019) demonstrate a significant correlation between body mass index (BMI) and disease severity in psoriatic arthritis .

Psoriatic arthritis is a chronic inflammatory disease that affects the skin and joints and causes pain and disability. The disease often causes swelling of the fingers and toes, mainly because of inflammation of the joints. Although psoriatic arthritis has been associated with an increased prevalence of obesity and overweight, few studies have evaluated the link between weight and severity of the disease in these patients.

The results of this study demonstrate that BMI is independently correlated with disease activity (p = 0.026), with the impact of the disease perceived by the patient (p <0.0001) and disability (p <0.0001). In patients with psA classified as obese or non-obese, the cDAPSA (range 0 to 154) of disease activity was 33.4 vs 27.7, the measure of the impact of the patient's perceived illness PsAID-12 (range 0 to 10) was 6.3 versus 5.3; the HAQ-DI disability measure (range 0 to 3) was 1.36 versus 1.03 respectively.

"Our findings highlight the impact of obesity and the need for lifestyle-oriented approaches to manage the weight of psoriatic arthritis alongside joint and skin treatments," said Dr. Stefan Siebert, clinical lecturer in inflammation and rheumatology, University of Glasgow, United Kingdom. .

The study included 917 patients from eight European countries as part of the PsABio study, a prospective prospective observational study evaluating patients with PsA receiving ustekinumab or factor inhibitors. tumor necrosis. The data collected on the severity and impact of the disease were analyzed using several regression models adjusted for age, sex, smoking, body surface area, C-reactive protein, the duration of the disease and the biological treatment.

There is growing evidence describing how adipose tissue acts as an active organ involved in metabolic and inflammatory disorders. In addition, with fixed dose regimens, as for self-injected biological products, obesity can reduce the effectiveness for pharmacokinetic reasons. "These factors, along with the global epidemic of overweight and obesity, make research in this area extremely useful and interesting."

Professor John D. Isaacs, Chair of the Abstract Selection Committee, EULAR

Another study presented today at EULAR 2019 provides evidence of adipokine, adiponectin, in predicting the development of rheumatoid arthritis in overweight subjects.

Adipokines are signaling molecules secreted by adipose tissue and act in the same way as hormones. High levels of adiponectin, a type of adipokine, have been demonstrated in subjects with rheumatoid arthritis. However, the results of this study suggest that it could play a role in predicting the onset of the disease.4

Early detection and management of rheumatoid arthritis are very important for improving disease outcomes in patients. Our analysis suggests that serum adiponectin in overweight patients could play a biomarker role in early rheumatoid arthritis. "

Cristina Maglio, MD, PhD, University of Gothenburg, Gothenburg, Sweden

The analysis included two studies. The first involved 82 subjects with obesity and available measures of adiponectin prior to the onset of rheumatoid arthritis and 410 matched controls. She has demonstrated a 10% increased risk of developing rheumatoid arthritis in patients with elevated serum adiponectin levels initially. The second study included 88 sex- and age-matched pairs and showed an increased risk of 20%, but only in those with a BMI greater than 25.4.

Finally, another interesting study presented today at the EULAR 2019 examined overweight and obesity in young patients with juvenile idiopathic arthritis (JIA).

The results showed that the rate of overweight and obesity in children and adolescents with JIA was comparable to that of the general population. However, further analysis revealed that a number of factors are significantly associated with being overweight in the AIJ group, especially age (OR: 1.06, 95% CI: 1, 04-1.09), male sex (OR: 1.21, 95% CI: 1.04-1.44). ), functional limitations (OR: 1.29, 95% CI: 1.04-1.59), treatment with biologic DMARDs (OR: 1.48, 95% CI: 1.22-1.80) and systemic glucocorticoids (OR: 1.40, 95% CI: 1.14-1.71). The implications of these findings for the long-term outcomes of the JIA need to be further explored.


European League Against Rheumatism