Obese Patients with RA Have a More Seropositive and a More Active Disease with Less Deformities

Adeeba Al-Herz¹, Adel Al-Awadhi², Khulood Saleh³, Waleed Al-Kandari³, Eman Hasan⁴, Aqeel Ghanem⁵, Fatemah Abutiban⁶, Ahmad Alenizi⁶, Mohammad Hussain⁴, Yaser Ali⁵, Ibrahim Nahar⁵, Ali Aldei¹, Hebah Alhajeri⁵, Sawsan Hayat⁵, Ahmad Khadrawy³, Ammad Fazal³, Khaled Mokaddem¹, Ajaz Zaman⁵, Ghada Mazloum⁵, Youssef Bartella¹, Sally Hamed¹ and Ahmed Al-Saber⁷, ¹Rheumatology, Al-Amiri Hospital, Kuwait city, Kuwait, ²Faculty of Medicine, Kuwait, Kuwait, ³Rheumatology, Farwania Hospital, Farwania, Kuwait, ⁴Al-Amiri Hospital, Kuwait city, Kuwait, ⁵Rheumatology, Mubarak Al-Kabeer Hospital, Hawally, Kuwait, ⁶Rheumatology, Jahra Hospital, Jahra, Kuwait, ⁷Department of Mathematics, Kuwait Technical College, Kuwait city, Kuwait

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: obesity, registry and rheumatoid arthritis (RA)

Session Information

Date: Monday, November 14, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster II: Co-morbidities and Complications

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: An association between obesity and RA activity has been proposed in the literature. Kuwait has the highest obesity rate in The Middle East and is ranked among the top 10 most obese countries in the world. We describe obese patients with RA and study the influence of body mass index (BMI) on RA activity and severity.

Methods: Adult patients from The Kuwait Registry for Rheumatic Diseases (KRRD) who satisfied the ACR classification criteria for RA from four major hospitals were studied from February 2013 through December 2015. Patients were classified using WHO criteria to underweight (<18.5), normal (18.5-24.99), pre-obese (25-29.99) and obese (>30). Their demographic, clinical and serological features were compared. Statistical tests were applied where appropriate.

Results: A total of 425 RA patients with1615 hospital visits and available BMI were identified, 351 (82.6%) were females. The mean age was 52.6 years (18-86) and disease duration 6.7+7.2 years (0.1-46). Among them, 156 (36.7%) were obese, 177 (41.6%) were pre-obese, 89 (21%) were normal and 3 (0.7%) were underweight. Based on DAS28 scores, 257 (60.5%) were in remission or had low disease activity, 146 (34.4%) had a moderate disease activity and 22 (5.1%) had a severe disease activity. Patients with a higher BMI were diagnosed at an older age (p=0.02). BMI was positively correlated to DAS28 (p=0.03), CDAI (p=0.006), ESR (p<0.001), CRP (p=0.02), tender joint count (p=0.022), swollen joint count (p=0.012), positive rheumatoid factor (RF) (p=0.014), positive anti-citrullinated protein antibodies (ACPA) (p=0.029) and a combination of positive RF and ACPA (p<0.001). Increased BMI was associated with a lower VAS pain (p=0.022), a lower patient’s global assessment of disease activity (p=0.027) and less deformities (p<0.001). There was no significant association with gender, HAQ score, sicca symptoms, rheumatoid nodules or other extra-articular features. Biologic therapy was more prescribed to patients with a higher BMI score (p=0.005).

Conclusion: The distribution of BMI among RA patients in Kuwait was similar to the general population with the majority being overweight. Patients with a higher BMI had a more seropositive and a more active RA but less deformities. We recommend that BMI is measured and approached in all RA patients and that overweight patients are aggressively managed to control disease activity.

Disclosure: A. Al-Herz, None; A. Al-Awadhi, None; K. Saleh, None; W. Al-Kandari, None; E. Hasan, None; A. Ghanem, None; F. Abutiban, None; A. Alenizi, None; M. Hussain, None; Y. Ali, None; I. Nahar, None; A. Aldei, None; H. Alhajeri, None; S. Hayat, None; A. Khadrawy, None; A. Fazal, None; K. Mokaddem, None; A. Zaman, None; G. Mazloum, None; Y. Bartella, None; S. Hamed, None; A. Al-Saber, None.

To cite this abstract in AMA style:

Al-Herz A, Al-Awadhi A, Saleh K, Al-Kandari W, Hasan E, Ghanem A, Abutiban F, Alenizi A, Hussain M, Ali Y, Nahar I, Aldei A, Alhajeri H, Hayat S, Khadrawy A, Fazal A, Mokaddem K, Zaman A, Mazloum G, Bartella Y, Hamed S, Al-Saber A. Obese Patients with RA Have a More Seropositive and a More Active Disease with Less Deformities [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/obese-patients-with-ra-have-a-more-seropositive-and-a-more-active-disease-with-less-deformities/. Accessed .

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