Spondyloarthritis & psoriatic arthritis
High BMI is associated with lower TNF-α inhibitor serum trough levels and higher disease activity in patients with axial spondyloarthritis
Authors' conclusion
In this cross-sectional, observational study of axSpA patients mainly on long-term treatment with TNFi, higher BMI was significantly associated with lower adalimumab and etanercept serum trough levels and higher disease activity.
Study context
- Population
- Consecutive axial spondyloarthritis (axSpA) patients from the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) cohort on TNFi, mainly long-term, regular outpatient visit at the UMCGmedian treatment duration 41 months
- Participants
- 34 vs 21
- Exposure
- TNFi serum trough levels vs disease activity and BMI
- Adalimumabn = 34
- Etanerceptn = 21
- Outcome
- Relation of TNFi serum trough levels with disease activity (ASDAS-CRP) and BMI
Methodological detailsobservational, consecutive patients, Spearman's correlation, logistic regression
- Observational
- Consecutive patients
- Spearman's correlation
- Logistic regression
Main finding
As reported in the abstract
| Group | ρ with ASDAS-CRP | ρ with BMI |
|---|---|---|
| Adalimumab | −0.16 (p = 0.39) | −0.48 (p = 0.004) |
| Etanercept | −0.29 (p = 0.20) | −0.50 (p = 0.021) |
ρ with ASDAS-CRP
Adalimumab−0.16 (p = 0.39)
Etanercept−0.29 (p = 0.20)
ρ with BMI
Adalimumab−0.48 (p = 0.004)
Etanercept−0.50 (p = 0.021)
Observational data: associations, not effects.
Further findings
Median
| Outcome | Active disease | Inactive disease | P value |
|---|---|---|---|
| BMI, active (ASDAS ≥ 2.1) vs inactive disease | 29.7 | 24.6 | P = 0.015 |
Therapeutic serum trough levels (Sanquin definitions)
- Patients with therapeutic serum trough levels
- 47%
Multivariable regression: therapeutic drug levels and ASDAS
- BMI the only confounder for the relationship between therapeutic drug levels and ASDAS
Original publication
High BMI is associated with lower TNF-α inhibitor serum trough levels and higher disease activity in patients with axial spondyloarthritis. Arthritis Res Ther. Published 17 October 2023. doi:10.
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