Obesity and its associations with clinical manifestations and disease burden of patients with spondyloarthritis: An ancillary study from the ASAS-PerSpA project.

OBJECTIVE

This study aims to explore the relationship of obesity with clinical manifestations and disease burden including biologic/targeted DMARD (btDMARD), SpA-related surgery, work productivity loss, and patient-reported health status.

METHODS

An ancillary analysis of the Assessment of Spondyloarthritis International Society PerSpA (PERipheral involvement in SpA) cross-sectional study from 24 participating countries. The PerSpA study included the data of clinical characteristics, btDMARD use and history (number of btDMARD kinds ever-prescribed, number of discontinuation, and the reasons for discontinuation), SpA-related surgery, work productivity and activity impairment, and patient-reported health status (ASAS Health Index, Bath Ankylosing Spondylitis Functional Index, and global wellbeing). Patients were divided into three groups according to the current BMI (BMIc) and comparisons between the obese patients, overweights, and normal weights were performed for the above-mentioned parameters. The study population was also divided into different three groups according to their 20-year-old BMI (BMI20y) and they were compared in itself.

RESULTS

Among the 4449 patients, 34.6% were overweight, 21% obese, and 44.4% normal-weight. Obese/overweight patients had a higher btDMARD burden, btDMARD inefficacy, work impairment, and worse patient-reported health (p < 0.05 for all). The differences were preserved in comparisons adjusted for age, gender, and smoking. When the patients were compared according to their BMI20y, similar differences were also found.

CONCLUSIONS

Obesity invites a biological therapy burden, work productivity loss, and worse patient-reported health status in patients with SpA.