Background/Purpose: Recent studies have shown the impact of obesity on achieving low disease activity (LDA) or remission in rheumatoid arthritis (RA) patients treated with TNF inhibitors (TNFi). However, there remains a lack of research on the effects of obesity on clinical responses to non-TNF-targeted treatments. This study investigated the influence of body mass index (BMI) on the clinical response to non-TNF-targeted treatments in patients with RA.

Methods: Patients from the KOBIO registry who had received at least one prescription for non-TNF-targeted treatments, including abatacept, tocilizumab, and JAK kinase inhibitors, were included. They were categorized into three BMI groups: under 25 kg/m² (434 patients), between 25 and 30 kg/m² (146 patients), and over 30 kg/m² (22 patients). After one year of treatment, we compared the treatment continuation rate and clinical responses across these BMI categories. The time on treatment for each category was compared using Kaplan–Meier curves and Cox regression analyses, with adjustments for potential confounders.

Results: After one year of treatment, patients in the highest BMI category exhibited significantly lower treatment continuation rates and less improvement in their DAS28-ESR scores than those in the lowest BMI category (all P < 0.05). In multivariable Cox proportional hazard analysis, patients in the highest BMI category were more likely to discontinue their treatment than those in the lowest BMI category (HR 3.407, 95% CI 1.157-10.211; P = 0.029).

Conclusion: These findings underscore the necessity for individualized treatment approaches for RA patients with higher BMI, suggesting a differential response to non-TNF-targeted treatments based on BMI.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-body-mass-index-and-the-persistence-of-non-tnf-targeted-biologics-in-patients-with-rheumatoid-arthritis/