Background/Purpose: Physical activity is associated with a reduced risk of rheumatoid arthritis (RA). However, it is unclear whether the ‘weekend warrior’ (WW) pattern, characterized by achieving the majority moderate-to-vigorous PA (MVPA) with 1-2 days, offers similar benefits for incident RA to a more evenly distributed pattern. This study aimed to explore the association of accelerometer-deviced WW and other patterns patterns with incident RA, and the modification effect by genetic susceptibility.

Methods: A total of 89,241 participants from the UK Biobank without a prior diagnosis of RA and with a complete week of accelerometer-based physical activity data (collected between 2013 and 2015) were included. Participants were categorized according to guideline-based thresholds: inactive (< 150 min/week), active WW (≥150 min/week with ≥50% of total MVPA accrued in 1–2 days), and regularly active (≥150 min/week but not meeting the active WW criteria). A polygenic risk score for RA was was used for further assessing the interactions and joint effects of genetic risk and activity pattern. The associations between different activity patterns and incident RA were evaluated using multivariable Cox proportional hazards models, adjusting for potential confounders.

Results: During a mean follow-up of 7.8 years, 675 individuals developed RA. Overall, a nonlinear inverse relationship was observed between total MVPA and incident RA (P for nonlinearity = 0.003). Compared to inactive group, both the active WW (HR = 0.60, 95%CI, 0.50-0.71) and regular active (HR = 0.62, 95%CI, 0.50-0.77) group exhibited a similarly reduced risk of RA. When WW and regular activity were compared directly, there were no statistically significant difference. Similar findings were observed when applying the median MVPA threshold of ≥230.4 min/week. No significant interaction between genetic risk of RA and activity pattern was observed. Moreover, participants with an active WW pattern and low genetic risk had the lowest risk of incident RA (HR = 0.33, 95%CI, 0.23-0.46) compared with inactve individuals with low genetic risk.

Conclusion: Both concentrated MVPA accumulated over 1 to 2 days and evenly distributed physical activity were associated with a reduced risk of developing RA, even in the high and middle genetic risk group. These findings suggest that meeting MVPA guidelines—whether through a WW or regular pattern—may mitigate RA risk even in individuals with elevated genetic predisposition.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/accelerometer-derived-weekend-warrior-physical-activity-genetic-susceptibility-and-incident-rheumatoid-arthritis-a-prospective-cohort-study/