Document Detail

High BMI is associated with decreased treatment response to combination therapy in recent onset RA patients- a subanalysis from the BeSt study.
MedLine Citation:
PMID:  23408767     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To assess the association between high body mass index (BMI) and treatment response in recent onset RA. METHODS: In the BeSt study, 508 patients were randomized to initial monotherapy or combination therapy with prednisone or infliximab (IFX). Response to disease activity score (DAS)≤2.4 steered treatment (first dose and after 1 year) was compared between patients with a BMI <25 and ≥25, using relative risk regression analyses. DAS, components of DAS and functional ability during the first year were compared using linear mixed models. RESULTS: High BMI was independently associated with failure to achieve DAS≤2.4 on initial therapy, RR 1.20 (1.05-1.37). The effect for combination therapy with prednisone was RR 1.55 (1.06-2.28) and for combination therapy with IFX 1.42 (0.98-2.06). The RRs for failure after one year were 1.46 (0.75-2.83) and 2.20 (0.99-4.92) respectively. High BMI was also associated with failure on delayed combination therapy with IFX, after adjustment for selection bias related to previous failure on DMARDs. No significant association was observed in the initial monotherapy groups. In the first year, patients with a high BMI had higher DAS and worse functional ability, with more tender joints and a higher VAS global health, but not more swollen joints and similar systemic inflammation. CONCLUSIONS: High BMI was independently associated with failure to achieve low DAS on initial combination therapy with prednisone and on initial and delayed treatment with infliximab. Patients with a high BMI experienced more pain, but not more swelling or systemic inflammation. © 2013 by the American College of Rheumatology.
L Heimans; M van den Broek; S le Cessie; B Siegerink; N Riyazi; K H Han; P J S M Kerstens; T W J Huizinga; W F Lems; C F Allaart
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-13
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 by the American College of Rheumatology.
Department of rheumatology, LUMC, Leiden, The Netherlands.
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