Obesity is a risk factor for poor response to treatment in early rheumatoid arthritis: a NORD-STAR study

Area of Science:

• Rheumatology
• Clinical Trials
• Obesity Research

Background:

• Early rheumatoid arthritis (RA) management aims for remission.
• The impact of obesity on treatment response in early RA is not fully understood.
• The NORD-STAR trial provides a platform to investigate this association.

Purpose of the Study:

• To assess the association between obesity and treatment response in early RA.
• To evaluate if obesity affects response to conventional and biological antirheumatic treatments.

Main Methods:

• Analysis of 793 participants with early RA from the NORD-STAR trial.
• Baseline body mass index (BMI) categorized participants into obese (BMI ≥30 kg/m²) and non-obese groups.
• Participants received one of four randomized treatments: conventional, certolizumab-pegol, abatacept, or tocilizumab.
• Treatment response assessed using CDAI, SDAI remission, and DAS28-CRP <2.6 at 48 weeks.

Main Results:

• 20% of participants (161/793) had obesity at baseline.
• Obese participants exhibited higher disease activity during follow-up compared to non-obese individuals.
• Obesity was associated with a reduced likelihood of achieving treatment response (CDAI, SDAI, DAS28-CRP remission).
• The impact of obesity on treatment response was consistent across all treatment arms.

Conclusions:

• Obesity is associated with a lower likelihood of achieving good treatment response in early RA.
• This association is independent of the specific conventional or biological antirheumatic treatment received.
• Findings highlight the importance of considering obesity in RA management strategies.