Background/Purpose: Obesity is considered a controversial risk factor for developing rheumatoid arthritis (RA), and the association between weight change and RA incidence is inconclusive. The aim of our study was to investigate the effect of weight loss after bariatric surgery on the incidence of RA among obese patients.

Methods: This nonrandomized retrospective study analyzed data extracted from the Maccabi Healthcare Services (MHS) database, including 9583 patients who underwent bariatric surgery and 9583 matched patients (by age and sex) in the control group. The follow-up period ranged from 01.01.2010 to 30.12.2020. The primary endpoint of our study was RA diagnosis after bariatric surgery. Cases of incident RA were identified through the MHS Register by searching for the RA diagnosis (ICD-714 code) plus one of the following: 1. The diagnosis was made by rheumatologist 2. Positive rheumatoid factor, or anti–cyclic citrullinated peptide, or 3. At least one disease-modifying anti-rheumatic drug therapy was prescribed.

Results: The final number of patients was 9583 for each of the bariatric surgery and control groups. The mean follow-up period was 7.31 years. Among the 19166 subjects, 18 were diagnosed with RA during follow-up, 9 in the bariatric group (0.09%) and 9 in the control group (0.09%). The mean age of the patients who developed RA was 49.89 years, and half of the patients were males. Male sex was correlated with an increased risk for developing RA only in patients with a BMI >40.

Conclusion: We did not observe any association between weight loss after bariatric surgery and the incidence of RA in subjects with obesity during the 10-year follow-up period.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-association-between-bariatric-surgery-and-incident-rheumatoid-arthritis/