Background The levels of inflammation markers, specifically C-reactive protein (CRP), are known to be elevated in patients with excessive body weight.
Objectives To evaluate the efficacy of 12-month therapy with SC MTX in patients with recently emerged RA with different BMI.
Methods MTX-naive patients with active early RA (<6 months) diagnosed in accordance with ACR/EULAR 2010 or ACR 1987 (DAS28>3.2) before inclusion were eligible for the 12-month open study. Patients were divided into 3 groups depending on the BMI: I ≤25 kg/m2, II =25–30 kg/m2, III ≥30 kg/m2. Monotherapy with SC MTX once weekly was administered to all patients; starting dose – 10–15 mg per week with escalation of 5 mg every 1–2 weeks (maximum dose – 30 mg per week) until treatment targets were reached (DAS28≤2.6) or adverse events (AE) appeared. Given that patients received almost identical single doses of SC MTX, but had different BMI, we have calculated the dose in mg per m2, calling it the actual dose (AD). Folic acid was administered at the dose of at least 5 mg per week on any day(s) except for the date of SC MTX administration. Disease activity was determined using DAS28ESR, DAS28CRP and SDAI. Remission was determined in accordance with ACR/EULAR 2011 criteria.
Results 47 patients (38 female, 9 male) with mean RA duration of 4.2±1.7 months and mean age of 51.0±13.2 years were included. There were no differences between groups defined on the basis of BMI in gender, disease duration, rheumatoid factor, baseline disease activity. The majority of patients have not received DMARD or glucocorticoids (GC) before. After 3, 6 and 12 months of monotherapy with SC MTX we received different results between groups (see table). AE were similar in all groups at each time point.
Conclusions Treatment effect of SC MTX in patients with recently emerged RA correlates with BMI and is significantly increased in patients with normal BMI (≤25 kg/m2) than in patients with excessive body weight or obesity.
Disclosure of Interest None declared
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