The impact of obesity and overweight on rheumatoid arthritis patients: real-world insights from a biologic and targeted synthetic DMARDs registry.

The Impact of Obesity and Overweight on Rheumatoid Arthritis Patients: Real-World Insights from a Biologic and Targeted Synthetic DMARDs Registry. The management of rheumatoid arthritis (RA) has advanced with biological and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). However, obesity, a common comorbidity, impacts treatment and disease progression efficacy. This article examines the association between body weight, activity of the disease and the effectiveness of b/tsDMARDs in RA patients. This multicenter observational cohort study, conducted as part of the BioSTAR Registry, involved a total of 856 patients diagnosed with RA (168 males and 688 females). Patients were separated into groups based on BMI: Group 1 ("normal BMI: ≥18.5 to < 25 kg/m2 or underweight BMI: <18.5 kg/m2") and Group 2 ("overweight BMI: ≥25 to < 30 kg/m2 or obese BMI: ≥30 kg/m2"). Baseline socio-demographic and clinical data, medication use, switching status, and total glucocorticoid dose (mg-year) were collected. Age, disease duration, disease activity scores were considerably higher in obesity/overweight patients. Remission rates were lower in obese/overweight patients (35.6% and 25.9% in group 1 and 2 respectively; p = 0.026). The cumulative steroid doses, number of biologics and switches were similar between groups, regardless of pharmacological mechanisms. Regression analysis indicated that BMI was one of the factors affecting DAS28-CRP. The obesity/overweight rate is as high as 70.4% in RA patients. While obesity/overweight is related to enhanced disease activity, lower remission rates in RA, its effect on the choice and switch rates of b/tsDMARDs appears minimal. Clinical effectiveness remains consistent across drug classes, regardless of BMI.