Gardette A, Ottaviani S, Sellam J, Berenbaum F, Lioté F, Meyer A, Sibilia J, Fautrel B, Palazzo E, Dieudé P
CHU Bichat Claude Bernard, Service de Rhumatologie, Université Paris Diderot, Hôpital Bichat, AP-HP, 46 rue Henri Huchard, 75018, Paris, France.
CHU Saint Antoine, Service de Rhumatologie, DHU i2B and Inserm UMRS_938, Université Pierre et Marie Curie, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France.
Clin Rheumatol. 2016 Apr;35(4):857-61. doi: 10.1007/s10067-016-3183-3. Epub 2016 Jan 22.
Several studies have suggested that obesity could have a negative effect on response to anti-tumor necrosis factor α (anti-TNFα) in rheumatoid arthritis (RA). Little is known about the impact of body mass index (BMI) on other biologic agents. We aimed to evaluate the effect of BMI on response to tocilizumab (TCZ) in RA. RA patients treated with TCZ were included in this multicenter retrospective study. BMI was calculated at the initiation of treatment. After 6 months of treatment, change from baseline in DAS28, pain on a visual analog scale, erythrocyte sedimentation rate and C-reactive protein level, and tender and swollen joints were analyzed. The primary endpoint was decrease in DAS28 ≥ 1.2. Secondary outcomes were good response and remission by EULAR criteria. At baseline, among 115 RA patients included, the median (interquartile range) BMI was 25.4 (22.0-28.8) kg/m(2). The number of patients with normal weight, overweight, and obesity was 53 (46 %), 37 (32 %), and 25 (22 %), respectively. Baseline characteristics did not differ between the three subgroups of BMI. The median BMI did not differ between responders and non-responders for DAS28 decrease ≥1.2 (25.7 [22.1-29.9] vs 24.9 [22.0-27.1], P = 0.38), EULAR good response (25.9 [22.8-30.0] vs 25.4 [22.0-28.4], P = 0.61), and remission (25.1 [22.5-28.6] vs 25.4 [22.0-28.9], P = 0.76). BMI did not affect the response to TCZ in RA. If confirmed, these results could be helpful for the selection of a biologic agent in obese RA patients.
多项研究表明，肥胖可能会对类风湿关节炎（RA）患者对抗肿瘤坏死因子α（抗TNFα）的反应产生负面影响。关于体重指数（BMI）对其他生物制剂的影响，人们了解甚少。我们旨在评估BMI对RA患者使用托珠单抗（TCZ）治疗反应的影响。本多中心回顾性研究纳入了接受TCZ治疗的RA患者。在治疗开始时计算BMI。治疗6个月后，分析DAS28从基线的变化、视觉模拟量表上的疼痛、红细胞沉降率和C反应蛋白水平，以及压痛和肿胀关节。主要终点是DAS28降低≥1.2。次要结局是根据欧洲抗风湿病联盟（EULAR）标准的良好反应和缓解。在基线时，纳入的115例RA患者中，BMI的中位数（四分位间距）为25.4（22.0 - 28.8）kg/m²。体重正常、超重和肥胖的患者人数分别为53例（46%）、37例（32%）和25例（22%）。BMI的三个亚组之间基线特征无差异。对于DAS28降低≥1.2的反应者和无反应者，BMI中位数无差异（25.7 [22.1 - 29.9] 与24.9 [22.0 - 27.1]，P = 0.38），EULAR良好反应者（25.9 [22.8 - 30.0] 与25.4 [22.0 - 28.4]，P = 0.61），以及缓解者（25.1 [22.5 - 28.6] 与25.4 [22.0 - 28.9]，P = 0.76）。BMI不影响RA患者对TCZ的反应。如果得到证实，这些结果可能有助于肥胖RA患者生物制剂的选择。
