A new study presented today at EULAR 2013, the Annual Congress of the European League Against Rheumatism, shows that overweight and obese patients are less likely to achieve successful remission in early rheumatoid arthritis (ERA) compared to those of normal weight. Obese and overweight ERA subjects required 2.4 times more anti-TNF therapy throughout the study than normal weight participants without achieving similar remission outcomes.
“There is an urgent need to address the issues of overweight and obesity to improve patients’ chance of successful remission.” 346 ERA patients with symptom duration <12 months were categorized into one of three BMI† classes (normal weight, overweight and obese) and treated according to a treat-to-target strategy aimed at remission. The strategy included strict follow-up visits, treatment with methotrexate up to 25mg/week+steroids, and combination with a TNF blocker if at least a good response according to EULAR criteria* was not obtained. † BMI, Body Mass Index; measure of body fat defined as body mass divided by the square of an individual’s height. Normal weight BMI <25 kg/m2 , overweight 25-30 kg/m2 , obese >30 kg/m2. Data demonstrate that overweight and obese patients reached a lower rate of remission, both with DAS and CDAI‡ criteria, at 6 and 12 month follow-up visits. A higher percentage of obese and overweight ERA patients were under anti-TNF treatment after 12 months of follow-up compared to normal weight.
* EULAR response criteria; individual patients classified as non-, moderate, or good responders,
dependent on the extent of change and the level of disease activity reached
‡ DAS, Disease Activity Score; clinical index of RA disease activity that combines information from
swollen joints, tender joints, the acute phase response and general health. CDAI is a composite index
(without acute-phase reactant) for assessing disease activity and is based on the summation of the
count of swollen/tender joint count of 28 joints along with patient and physician global assessment on
VAS (0–10cm) Scale for estimating disease activity
1. Gremese AL et al., The body mass index: a determinant of remission in early rheumatoid arthritis
[abstract]. EULAR Annual European Congress of Rheumatology; 12-15 June 2013; Madrid,
Spain. Abstract nr. OP0178.
2. Chronic diseases and Health Promotion: Chronic Rheumatic Conditions, World Health
Organisation. Available from: http://www.who.int/chp/topics/rheumatic/en/. Last accessed: May
3. Non communicable Diseases: Obesity, World Health Organization. Available from:
Last accessed: May 2013
4. Fransen, J & van Riel P, The Disease Activity Score and the EULAR response criteria, Clinical
and Experimental Rheumatology, Nov;35(4):745-57