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Weight loss and achievement of minimal disease activity in patients with psoriatic arthritis starting treatment with tumour necrosis factor α blockers
  1. Matteo Nicola Dario Di Minno1,
  2. Rosario Peluso2,
  3. Salvatore Iervolino3,
  4. Anna Russolillo1,
  5. Roberta Lupoli1,
  6. Raffaele Scarpa2,
  7. on behalf of the CaRRDs Study Group
  1. 1Regional Reference Center for Coagulation Disorders, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
  2. 2Rheumatology Research Unit on Psoriatic Arthritis, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
  3. 3Reumatology and Rehabilitation Research Unit, ‘Salvatore Maugeri’ Foundation, Scientific Institute of Telese Terme (BN), Italy
  1. Correspondence to Dr Matteo Nicola Dario Di Minno, Regional Reference Center for Coagulation Disorders, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; dario.diminno{at}hotmail.it

Abstract

Objectives To evaluate prospectively the effect of weight loss on the achievement of minimal disease activity (MDA) in overweight/obese patients with psoriatic arthritis (PsA) starting treatment with tumour necrosis factor α (TNFα) blockers.

Methods Among subjects with PsA starting treatment with TNFα blockers, 138 overweight/obese patients received a concomitant dietary intervention (69 a hypocaloric diet (HD) and 69 a free-managed diet (FD)). Changes in metabolic variables were measured and a complete clinical rheumatological evaluation was made in all patients at baseline and after a 6-month follow-up to define the achievement of MDA.

Results 126 subjects completed the study. MDA was more often achieved by HD than by FD subjects (HR=1.85, 95% CI 1.019 to 3.345, p=0.043). A diet was successful (≥5% weight loss) in 74 (58.7%) patients. Regardless of the type of diet, after 6 months of treatment with TNFα blockers, ≥5% of weight loss was a predictor of the achievement of MDA (OR=4.20, 95% CI 1.82 to 9.66, p<0.001). For increasing weight-loss categories (<5%, 5–10%, >10%), MDA was achieved by 23.1%, 44.8% and 59.5%, respectively. A higher rate of MDA achievement was found in subjects with 5–10% (OR=3.75, 95% CI 1.36 to 10.36, p=0.011) and in those with >10% (OR=6.67, 95% CI 2.41 to 18.41, p<0.001) weight loss in comparison with those with <5% weight loss.

Conclusions Regardless of the type of diet, a successful weight loss (≥5% from baseline values) is associated with a higher rate of achievement of MDA in overweight/obese patients with PsA who start treatment with TNFα blockers.

  • Psoriatic Arthritis
  • Disease Activity
  • TNF-alpha

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