Overweight and obesity reduce the likelihood of achieving sustained remission in early rheumatoid arthritis: results from the canadian early arthritis cohort study

Obesity is a modifiable risk factor for rheumatoid arthritis (RA), and weight management for persons with excess weight is recommended to optimize disease outcomes and reduce mortality. But none of the studies examined potential associations of being overweight with sustained remission. Therefore, the results of the present study demonstrate the negative impact of excess weight on RA disease activity.  

Obesity shows a correlation with RA severity, development, results and treatment response. This study involved the evaluation of independent consequences of obesity and overweight on the capability to attain sustained remission (sREM) in the three years after the diagnosis of rheumatoid arthritis (RA).

The information was sustained from the Canadian Early Arthritis Cohort, a multicenter observational analysis of early RA patients cured by rheumatologists employing guideline-based care. The DAS28 <2.6 for two consecutive visits was considered as sREM. Further, BMI was to stratified patients, healthy exhibited 18.5-24.9 BMI, overweight exhibited 25-29.9 BMI, and obese exhibited ≥30 BMI. Adjusting for sex, race, age, RA duration, smoking status, education, baseline DAS28, HAQ-DI, CRP, comorbidities and initial treatment, estimation of BMI impact on the probability of attaining sREM over the first three years was done using Cox regression.  

Within three years, 315, 343, and 324 out of the total 982 patients exhibited healthy, overweight and obese BMI, respectively and 355 obtained the sREM. No difference of BMI category was seen on initial treatment. Overweight and obese patients exhibited considerably less sREM achievement as compared to healthy subjects.

Incidences of overweight and obesity were more (69%) among this ERA cohort. Obese subjects were 47%, and overweight subjects were 25% less likely to obtained sREM in the first three years regardless of same initial DMARD treatment and subsequent biologic use. This is the largest study revealing the adverse effect of excess weight on RA disease activity and assists a call to action to better recognize and address this risk in RA patients.