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

  • Rheumatoid Arthritis (L Moreland, Section Editor)
  • Published:
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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.

Summary

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.

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Data Availability

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgments

Dr. Baker would like to acknowledge funding through a Veterans Affairs Clinical Science Research & Development Merit Award (I01 CX001703). The contents of this work do not represent the views of the Department of the Veterans Affairs or the United States Government.

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Funding

Dr. Baker is funded by a Veterans Affairs Clinical Science Research & Development Merit Award (I01 CX001703).

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Authors and Affiliations

  1. Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA

    Dilli Poudel, Michael D. George & Joshua F. Baker

  2. Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA

    Michael D. George & Joshua F. Baker

  3. Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA

    Joshua F. Baker

  4. Division of Rheumatology, Department of Medicine, Hospital of the University of Pennsylvania, 5 White Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Joshua F. Baker

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  1. Dilli Poudel
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JFB developed the idea for the article. DP and JFB performed literature searches, data analysis, drafted and critically revised the work. MDG critically revised the work.

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Correspondence to Joshua F. Baker.

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Poudel, D., George, M.D. & Baker, J.F. The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis. Curr Rheumatol Rep 22, 56 (2020). https://doi.org/10.1007/s11926-020-00933-4

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