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FRI0034 Impact of Obesity on Disease Activity and Radiographic Progression in a Cohort of Early Rheumatoid Arthritis: Results from Espoir Cohort
  1. C.I. Daien1,
  2. J. Sellam2,
  3. N. Rincheval3,
  4. B. Fautrel4,5,
  5. A. Saraux6,
  6. J. Morel1,
  7. J.-P. Daurès3,
  8. B. Combe1
  1. 1Rheumatology, CHRU Lapeyronie and UMR5535 CNRS, Montpellier
  2. 2Rheumatology, Hôpital Saint-Antoine APHP, Paris
  3. 3IURC, IURC, Montpellier
  4. 4Rheumatology, APHP, Pitie Salpetriere Hospital
  5. 5UPMC, IPLESP, GRC 08, Paris
  6. 6Rheumatology, CHRU, Brest, France

Abstract

Background Obesity is an increasing condition. Previous transversal studies suggested that obesity in patients with rheumatoid arthritis (RA) was associated with a higher disease activity, a poor quality of life and a lower radiographic damage but longitudinal studies are lacking.

Objectives We aimed to evaluate the impact of obesity at RA diagnosis on disease course including disease activity, health assessment questionnaire (HAQ-DI) and radiographic progression during the 3 first years.

Methods 628 patients from the French early arthritis ESPOIR cohort, fulfilling the 2010 ACR/EULAR criteria at baseline, were analyzed. Inclusion characteristics of normal weight (body mass index [BMI] 18.5 to 25), overweight (25-30) and obese (≥30 kg/m2) patients were compared using Khi2 and Kruskal Wallis. The outcome of DAS28 (and its components), HAQ-DI and Sharp score (and its components) was compared between BMI groups using repeated measures ANOVA and mixed models.

Results 353 patients had a normal BMI; 178 patients were overweight and 97 patients were obese. At baseline, obese patients were older and less frequently female, had lower rheumatoid factor levels, a higher Sharp score, lower C reactive protein and erythrocyte sedimentation rate, a higher insulin resistance, a lower practice of sport, higher IL-1RA and leptin levels, lower adiponectin and Dickkopf-related protein 1/sclerostin ratio. Repeated measures ANOVA showed a significant interaction between BMI groups and disease activity overtime with higher DAS28 (p=0.0002) (Fig. 1A), ESR (p=0.012) and disease activity on a visual analog scale (VAS) (p=0.002) and HAQ-DI (p=0.0001) (Fig. 1B) for obese patients. All these results were confirmed in mixed model using random effects model for time. Moreover, metabolic syndrome was associated with a higher DAS28 over time (p=0.011), independently of obesity. Total and erosion Sharp score were not significantly different between BMI groups whereas joint narrowing was significantly higher in obese patients (p=0.016)(Fig. 1C).

Conclusions Obesity at RA diagnosis is associated with a higher DAS28, a higher HAQ, a higher joint narrowing Sharp score over time but a similar total Sharp score than non-obese patients. Clinician should be aware of the differences that could influence the disease management.

Acknowledgements An unrestricted grant from Merck Sharp and Dohme (MSD) was allocated for the first 5 years of the ESPOIR study. Two additional grants from INSERM supported part of the biological database. The French Society of Rheumatology, Pfizer, Abbott, and Roche-Chugaï also supported the ESPOIR cohort.

Disclosure of Interest None declared

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