Date: Monday, November 6, 2017
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Adipose tissue produces several inflammatory mediators. Thus, obesity affects the disease course and the responses to the anti-rheumatic agents in inflammatory diseases. Several previous reports have documented that obesity decrease the response rate to anti-TNF-α agents in rheumatoid arthritis (RA). The aim of the study was to determine whether body mass index (BMI) is involved in the response to rituximab in RA.
Methods: Data on patient characteristics, diagnosis, previous treatment and outcomes have been collected since 2011 in Turkish Biologic (TURKBIO) Registry. By the end of May 2017, 206 RA patients, received rituximab from the TURKBIO registry, were included in the analysis. Demographic and clinical data including age, sex, disease type, disease duration, and previous or current treatment with DMARDs and biological drug durations are stored in the database. Kaplan-Meier survival analysis was performed to estimate the drug survival. Subgroups were compared by log-rank.
Results: 32.5% patients were normal/underweight, 67.5% were overweight and 28.6% were obese. Mean age, female percentage, DAS28-CRP and VAS were higher in obese patients than non-obese ones (Table 1). Rituximab treatment was ongoing 71.2% in obese and 63.3% in non-obese patients (p=0.279). Median drug survival duration was 77 months in obese patients and 62 months in non-obese ones (p=0.053). Estimated drug survival rates for rituximab were not statistically significantly different in the obese and non-obese patients (Fig. 1).
Conclusion: It is known that adipose tissue increases TNF-α level and enhances cellular immunity. Since its act on humoral immunity may be limited, obesity does not affect the response to rituximab.
References: 1. Iannone F, Fanizzi R, Notarnicola A, Scioscia C, Anelli MG, Lapadula G. Obesity reduces the drug survival of second line biological drugs following a first TNF-α inhibitor in rheumatoid arthritis patients. Joint Bone Spine. 2015;82:187-91. 2. Gardette A, Ottaviani S, Sellam J, Berenbaum F, Lioté F, Fautrel B, Palazzo E, Meyer A, Sibilia J, Dieudé P. Body mass index and response to abatacept in rheumatoid arthritis. Eur J Clin Invest. 2016;46:1048-52. 3. Ottaviani S, Gardette A, Roy C, Tubach F, Gill G, Palazzo E, Meyer O, Dieudé P. Body Mass Index and response to rituximab in rheumatoid arthritis. Joint Bone Spine. 2015;82:432-6.
To cite this abstract in AMA style:Koca SS, Karatas A, Oz B, Dalkilic E, Can G, Pehlivan Y, Yazici A, Inanc N, Cefle A, Erturk Z, Akar S, Senel S, Birlik M, Akkoc N, Onen F. Body Mass Index Does Not Affect Response to Rituximab in Patients with Rheumatoid Arthritis: Results from Turkbio Registry [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/body-mass-index-does-not-affect-response-to-rituximab-in-patients-with-rheumatoid-arthritis-results-from-turkbio-registry/. Accessed October 22, 2020.
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