Frew John W, Singh N, Jiang C S, Vaughan R, Krueger J G
Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, United States.
Department of Biostatistics, The Rockefeller University, New York, NY, United States.
Front Med (Lausanne). 2021 Jun 22;8:603281. doi: 10.3389/fmed.2021.603281. eCollection 2021.
Elevated BMI in Hidradenitis Suppurativa is associated with decreased response to Adalimumab therapy. BMI is proposed to segregate distinct disease subtypes. It remains unresolved whether a threshold BMI exists above which increased dosages may provide clinical benefit. Individual patient data from 578 PIONEER Phase 3 participants were analyzed. Descriptive, multivariable regression analysis and receiver operating characteristic (ROC) curves were calculated to assess the relationship between BMI and clinical outcome measures using R v3.5.3. Participants in the overweight and obese BMI category had reduced odds (58 and 67%, respectively) of achieving HiSCR [OR = 0.42 (95%CI -0.19, 0.91) = 0.03], [OR = 0.33 (95%CI 0.16, 0.67) = 0.002] compared to participants with BMI < 25. Reduction in AN count and IHS4 score was not significantly associated. ROC analysis did not reveal any cut off value predictive of treatment outcome. No correlation between BMI and baseline disease activity or covariate interactions were identified. These findings suggest BMI is a significant covariate in the setting of lower baseline disease activity, supporting the concept of disease heterogeneity and differential therapeutic response to Adalimumab.
化脓性汗腺炎患者体重指数（BMI）升高与阿达木单抗治疗反应降低相关。BMI被认为可区分不同的疾病亚型。目前仍未解决是否存在一个BMI阈值，超过该阈值增加剂量可能会带来临床益处。对578名PIONEER 3期参与者的个体患者数据进行了分析。使用R v3.5.3计算描述性、多变量回归分析和受试者工作特征（ROC）曲线，以评估BMI与临床结局指标之间的关系。与BMI<25的参与者相比，超重和肥胖BMI类别的参与者实现高临床反应（HiSCR）的几率分别降低了58%和67%[比值比（OR）=0.42（95%置信区间 -0.19, 0.91），P = 0.03]，[OR = 0.33（95%置信区间0.16, 0.67），P = 0.002]。腋窝结节计数（AN count）和IHS4评分的降低与BMI无显著相关性。ROC分析未发现任何可预测治疗结果的临界值。未发现BMI与基线疾病活动或协变量相互作用之间存在相关性。这些发现表明，在较低的基线疾病活动情况下，BMI是一个重要的协变量，支持疾病异质性和对阿达木单抗不同治疗反应的概念。
