Lower body mass and lower adiposity are associated with differential responses to two treatment strategies for rheumatoid arthritis
Authors' conclusion
Lower BMI and evidence of lower adiposity based on adipokine profiles were associated with a superior response to TNFi compared with triple therapy. There was no difference between treatments among overweight/obese participants.
Study context
- Population
- Rheumatoid arthritis (RA) patients with methotrexate inadequate response, in the RACAT and TEAR trialsRACAT n=306
- Comparison
- Tumour necrosis factor inhibitors (TNFi) vs triple therapy, by body mass index (BMI) and adipokine profile
- Primary endpoint
- Response to TNFi vs triple therapy (ACR20, change in DAS28) by BMI category and adipokine levels
Methodological detailssubgroup analysis by BMI and adipokine levels, regression adjusted for age, sex, BMI and baseline disease activity
- Subgroup analysis by BMI and adipokine levels
- Regression adjusted for age, sex, BMI and baseline disease activity
Primary result
As reported in the abstract
ACR20 response, normal/underweight participants (RACAT)
P = 0.001
- BMI × treatment interaction
- P for interaction = 0.001
Further findings
ACR20 response in the TEAR trial (n=601)
- Similar but modest patterns observed in TEAR; ACR20
- 67% vs 52%, p=0.05
ACR20 response by adipokine scores consistent with lower adiposity (RACAT)
- Adipokine scores consistent with lower adiposity predicted greater response to TNFi; ACR20
- 58% vs 37%, p=0.01
- Better model fit compared with BMI alone
Original publication
Lower body mass and lower adiposity are associated with differential responses to two treatment strategies for rheumatoid arthritis. Ann Rheum Dis. Published 12 March 2024. doi:10.
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