Document Detail

Body mass index and clinical response to infliximab in rheumatoid arthritis.
MedLine Citation:
PMID:  21061256     Owner:  NLM     Status:  Publisher    
OBJECTIVE:: Adipose tissue has immunomodulating effects in rheumatoid arthritis (RA), although the exact role is at present unclear. We investigated prospectively if body mass index (BMI) affects response to infliximab in RA patients. METHODS:: In 89 active RA patients BMI was calculated before initiation of infliximab treatment (3 mg/kg intravenously). After 16 weeks of treatment changes in disease activity were monitored by the disease activity score in 28 joints (DAS28). RESULTS:: Mean BMI was 26 kg/m(2) (SD 5, range 17-42) and it was positively correlated to baseline DAS28 (r = 0.34; P = 0.001). As selecting patients based on DAS28 could influence clinical response to TNF blockade due to regression to the mean, ANCOVA was used to correct for baseline DAS28. A highly significant, negative association between BMI and absolute decrease in DAS28 after 16 weeks (P = 0.001) was found. CONCLUSION:: Although infliximab dosage is based on body weight, RA patients with a high BMI responded less well to infliximab, also when adjusted for baseline DAS28 or ACPA status. These results support the notion that fat tissue may be involved in RA pathophysiology and could have implications for other immune-mediated inflammatory conditions treated with TNF antagonists.
Ruth Klaasen; Carla A Wijbrandts; Danielle M Gerlag; Paul P Tak
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-11-8
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  -     ISSN:  1529-0131     ISO Abbreviation:  -     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands.
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