The Weight on the Joints

Rheumatoid arthritis likelier to go into remission with normal body weight

/ Author:  / Reviewed by: Dominique Brooks, M.D Beth Bolt, RPh

(RxWiki News) When pain from arthritis hits the joints, it can be hard to deal with. Patients can get a better grip on their joint pain if they take control of their weight.

Overweight and obese patients with rheumatoid arthritis have less chance of having their achy joints ease up compared to normal weight patients, according to a recent study presented at a conference.

Though the findings have not yet been peer reviewed, they showed that a patient's weight is one of the few factors that can be modified and can affect whether rheumatoid arthritis goes into remission (when disease becomes inactive), the researchers found.

"Keep your weight in check."

The study, led by E. Gremese, PhD, from the Division of Rheumatology at Catholic University of the Sacred Heart in Rome, Italy, investigated whether body weight could affect the development, remission and treatment of rheumatoid arthritis.

About 340 patients with early rheumatoid arthritis (ERA) were included in the study. The patients were about 55 years of age on average and had arthritis symptoms for less than a year. More than three quarters of the patients were women.

The patients were treated with a treat-to-target strategy with the goal of putting the condition into remission. Patients were divided into one of three groups based on their body mass index (BMI), which is a measure of height and weight.

BMI classifications included normal weight (less than 25 kg/m2), overweight (between 25 and 30 kg/m2) and obese (over 30 kg/m2).

Almost half the participants were normal weight, 39 percent were overweight and a little more than 12 percent were considered obese.

Patients were instructed to attend all their follow-up appointments and were given up to 25 milligrams of methotrexate each week.

Afterwards, patients were given the medicine in combination with a TNF (tumor necrosis factor) blocker that targets the inflammation-causing cells in the body.

Fewer overweight and obese patients achieved arthritis remission compared to normal weight individuals six months and a year after starting treatment, the researchers found.

Almost half of the normal weight group went into remission, compared to 28.7 percent of the overweight group and 34 percent of the obese group.

A year after starting treatment, a higher percentage of obese and overweight patients with rheumatoid arthritis used anti-TNF treatment. In total, 28.1 and 28.8 of the two groups used the treatment, compared to 16.2 percent of the normal weight group.

"Overweight ERA subjects required 2.4 times more anti-TNF therapy, than normal weight to achieve the outcomes," the researchers wrote in their report. "BMI is one of the few modifiable variables influencing the major outcomes in rheumatoid arthritis."

Factors that affected whether patients hit remission included gender and being overweight.

Women were almost twice as likely to not achieve arthritis remission, and those with a BMI over 25 were 81 percent more likely of not reaching remission compared to other groups.

The study was presented at the EULAR Annual European Congress of Rheumatology June 12-15 in Madrid, Spain. No conflicts of interest were declared and outside funding information was not available.

Review Date: 
June 17, 2013
Last Updated:
August 2, 2013