rheumatoid arthritis (RA) patients experienced more rapidly progressing
disability than overweight patients, says a study on adults with the condition.
- A study involving adults with
rheumatoid arthritis has found that patients who were severely obese
experienced more rapidly progressing disability than patients who were
- The study also
implicates that patients who lost weight after enrolling in the study had
- Patients with
rheumatoid arthritis and obesity might benefit from intentional weight
loss through a comprehensive management strategy.
The disability was not due to signs
of arthritis like the amount of inflammation in their joints. Also, the weight
loss that occurred after the patients enrolled in the study was also associated
with worsening disability, possibly as a sign of frailty.
The study results are published online in Arthritis Care & Research.
on Weight Change and RA
Two earlier studies had also studied the effects of
weight change around RA diagnosis and risk of death.
‘Patients with rheumatoid arthritis who are severely obese and those who lose weight unintentionally tend to experience more rapidly progressing disability. These patients can benefit from intentional weight loss through a comprehensive management strategy.’
The first study looked at people who
were recently diagnosed with early RA and wanted to determine if being overweight
or obese have worse outcomes than healthy weight. The results showed
that overweight and obese patients were less likely to experience sustained
remission or decreased severity of the condition, compared with patients
with a healthy BMI, despite receiving similar treatments.
second study evaluated the effect of weight change in the early stages of RA on
subsequent mortality risk. Women who had severe weight
(>30 pounds) had the highest mortality rates after the early
to new research findings presented at the 2017 ACR/ARHP Annual Meeting in San
Diego, study author Dr.
Nikiphorou said that both obesity and higher RA disease activities increased a
patient's odds of higher disability and decreased the rates of remission. There is a growing recognition that the inflammatory
states mediated by obesity
those by inflammatory rheumatic diseases share common pathways.
Current Study - Effects
of Obesity in Patients with RA
Joshua Baker, MD, MSCE, of the Perelman School of Medicine
at the University of Pennsylvania, and his colleagues analyzed information
collected on 23,323 patients with rheumatoid arthritis from the National Data
Bank of the Rheumatic Diseases and data on 1697 patients from the Veterans
Affairs RA registry.
Results of the Study
- There is more rapid progression of
if the patient has severe obesity
- When patients (especially those who
were already lean)
lost weight they tended to become disabled more quickly.
The study authors are concluding that this weight loss is
unintentional and is the kind that occurs when people get older and acquire
"So, this study suggests that patients with rheumatoid
arthritis and obesity would benefit from intentional weight loss through a
comprehensive management strategy; however, when we see that someone is losing
weight without trying, it's probably a poor prognostic sign, especially if they
are already thin." said Dr. Baker.
of the Study
Obesity rates have been rising in recent years. Hence,
patients and rheumatologists, apart from focusing on disease activity, should
also consider that this common condition can contribute to problems that are
usually attributed to the arthritis itself.
Also, unintentional weight loss should be looked as a red
flag to indicate that the patient may be becoming frail and is at risk for
developing a new disability.
The findings can promote using new therapies and approaches
to weight loss in patients with arthritis, to help prevent disability over the
Health providers might be encouraged to recognize
unintentional weight loss as a poor prognostic sign and refer patients for
strength training, physical therapy, and other interventions to prevent
Rheumatoid arthritis (RA)
autoimmune disease where the body's immune system unintentionally
attacks the joints. This causes thickening of the tissue that lines the inside
of joints (the synovium), resulting in swelling and pain in and around the
joints. RA affects 1.5 million people in the United States alone and is more
common in women than in men.
- Joshua F. Baker, Bryant R. England, Ted R. Mikuls, Harlan Sayles, Grant W. Cannon, Brian C. Sauer, Michael D. George, Liron Caplan, and Kaleb Michaud. "Obesity, Weight Loss, and Progression of Disability in Rheumatoid Arthritis." Arthritis Care & Research; Published Online: April 30, (2018) DOI: 10.100/acr.23579.
- Elizabeth Schulman, Susan J. Bartlett, Orit Schieir, Kathleen M. Andersen, Gilles Boire, Janet E. Pope, Carol Hitchon, Shahin Jamal, J. Carter Thorne, Diane Tin, Edward C. Keystone, Boulos Haraoui, Susan M. Goodman, and Vivian P. Bykerk. "Overweight and Obesity Reduce the Likelihood of Achieving Sustained Remission in Early Rheumatoid Arthritis: Results from the Canadian Early Arthritis Cohort Study." Arthritis Care & Research; Published Online: November 30, (2017) DOI: 10.1002/acr.23457.