Kim Seong-Kyu, Choe Jung-Yoon, Park Sung-Hoon, Lee Hwajeong
Division of Rheumatology, Department of Internal Medicine, Arthritis and Autoimmunity Research Center, School of Medicine, Catholic University of Daegu, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, 705-718, Republic of Korea.
Clin Rheumatol. 2016 May;35(5):1129-36. doi: 10.1007/s10067-016-3220-2. Epub 2016 Mar 1.
The aim of this study was to determine whether body mass index (BMI) is associated with clinical response to biologics in patients with rheumatoid arthritis (RA). We enrolled 68 patients with RA who were treated with biological disease-modifying antirheumatic drugs (bDMARDs). Biologics included abatacept, tocilizumab, and tumor necrosis factor-α (TNF-α) blockers (etanercept and adalimumab). Baseline BMI (kg/m(2)) was classified as normal (BMI < 23.0), overweight (23.0 ≤ BMI < 25.0), or obese (BMI ≥ 25.0). Improvement of disease activity score 28 (DAS28) and achievement of the European League Against Rheumatism (EULAR) remission and responses between baseline and 24 weeks were our measures of clinical improvement. Mean baseline BMI before treatment with bDMARDs in patients with RA was 22.2 (SD 3.6). DAS28-ESR and DAS28-CRP were significantly reduced from baseline after 24 weeks of treatment with bDMARDs (p < 0.001 of both). ∆DAS28-ESR and ∆DAS28-CRP were not found among patients with normal, overweight, or obese BMI (p = 0.133 and p = 0.255, respectively) nor were EULAR responses or EULAR remission (p = 0.540 and p = 0.957, respectively). Logistic regression analysis showed no relationship of BMI with EULAR clinical responses (p = 0.093 for good response and p = 0.878 for EULAR remission). This study reveals that BMI is not a predictive factor of clinical response to bDMARDs in patients with RA.
本研究的目的是确定体重指数(BMI)是否与类风湿关节炎(RA)患者对生物制剂的临床反应相关。我们纳入了68例接受生物改善病情抗风湿药物(bDMARDs)治疗的RA患者。生物制剂包括阿巴西普、托珠单抗和肿瘤坏死因子-α(TNF-α)阻滞剂(依那西普和阿达木单抗)。基线BMI(kg/m²)分为正常(BMI<23.0)、超重(23.0≤BMI<25.0)或肥胖(BMI≥25.0)。疾病活动评分28(DAS28)的改善、欧洲抗风湿病联盟(EULAR)缓解的达成以及基线至24周之间的反应是我们衡量临床改善的指标。RA患者在接受bDMARDs治疗前的平均基线BMI为22.2(标准差3.6)。使用bDMARDs治疗24周后,DAS28-ESR和DAS28-CRP较基线显著降低(两者p均<0.001)。在BMI正常、超重或肥胖的患者中,未发现∆DAS28-ESR和∆DAS28-CRP有差异(分别为p = 0.133和p = 0.255),EULAR反应或EULAR缓解情况也无差异(分别为p = 0.540和p = 0.957)。逻辑回归分析显示BMI与EULAR临床反应无关(良好反应的p = 0.093,EULAR缓解的p = 0.878)。本研究表明,BMI不是RA患者对bDMARDs临床反应的预测因素。