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Review
. 2020 Aug 1;22(9):56.
doi: 10.1007/s11926-020-00933-4.

The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis

Dilli Poudel  1 , Michael D George  1   2 , Joshua F Baker  3   4   5   6
Affiliations
Review

The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis

Dilli Poudel et al. Curr Rheumatol Rep. .

Abstract

Purpose of the review: A growing number of studies have suggested that disease outcomes and response to therapy may be different in patients with rheumatoid arthritis (RA) who are obese. The goal of this review is to examine the most recent literature, with a focus on the impact of obesity on the assessment of disease activity and treatment outcomes in RA.

Recent findings: Obesity is common in patients with RA and can have a substantial impact on patient symptoms and outcomes. Obesity is associated with higher rates of chronic pain and opiate use, elevated inflammatory markers, and less reliable physical exam findings, making assessment of disease activity and treatment response more challenging. Despite seemingly worse clinical disease activity, evidence has accumulated demonstrating that obese patients with RA have less inflammation by imaging and lower rates of radiographic progression over time. Whether obesity influences the effectiveness of specific therapies remains controversial. Obesity is very common and is associated with more severe symptoms and higher rates of disability among RA patients. While clinical disease activity is frequently observed to be higher in obese patients with RA, it remains unclear whether poorer treatment response rates in this setting are related to reduced efficacy of therapies or are an artifact of biases in the accurate assessment of the disease.

Keywords: Adiposity; Body mass index; Obesity; Rheumatoid arthritis.

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Conflict of interest statement

Conflicts of Interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Conceptual model of the ways in which obesity can affect aspects of RA clinical manifestations and disease activity
Fig. 2
Fig. 2
Trim and fill plot demonstrating that there is evidence of publication bias in meta-analyses of studies evaluating the effects of obesity on response to therapy in RA
See this image and copyright information in PMC

References

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