<--GAT-->
Rheumatology

Obesity, Weight-Loss Both Worsen RA U.S. Medicine

by U.S. Medicine

October 14, 2018

PHILADELPHIA—Obese patients with rheumatoid arthritis report greater disability in cross-sectional studies, but what that means over the long term has not been studied often.

An article published in Arthritis Care & Research discussed evaluation of associations among obesity, weight loss and worsening of disability in two large registry studies with long-term follow-up.1

Philadelphia VAMC-led researchers included 23,323 patients with RA from the National Data Bank of Rheumatic Diseases (Forward) and the 1,697 patients from the VARA registry study. During the study, results of the Health Assessment Questionnaire (HAQ) or Multi-Dimensional (MD)-HAQ.

An increase of HAQ or MD-HAQ of &rt;0.2 was defined as significant worsening. The study team analyzed the risk of worsening from baseline, adjusting for demographics, baseline disability, comorbidity, disease duration and other disease features.

At enrollment, disability scores were higher among severely obese patients compared to overweight in both Forward [B: 0.17 (0.14, 0.20) p<0.001] and VARA [B: 0.17 (0.074, 0.27) p=0.001], the report noted.

Results indicated that, in multivariable models, patients who were severely obese at enrollment had a greater risk of progressive disability compared to overweight patients in Forward [HR 1.25 (1.18, 1.33) p<0.001] and VARA [HR 1.33 (1.07, 1.66) p=0.01].

Interestingly, weight loss following enrollment also was associated with a greater risk in both cohorts. Researchers pointed out that the associations were independent of other clinical factors, including time-varying C-reactive protein and swollen joint count in VARA.

“Severe obesity is associated with more rapid progression of disability in RA,” study authors concluded. “Weight loss is also associated with worsening disability, possibly by identifying individuals with chronic illness and the development of age-related or disease-related frailty.”


Comments are closed here.


Related Articles

HIV Patients Had Lower PC Incidence in VA Study

NEW YORK—Non-AIDS defining cancers are increasingly important contributors to health outcomes for aging persons with HIV (PWH), according to a recent conference presentation which also pointed out that, although prostate cancer is prevalent in aging... View Article

VA Study Finds No Link Between ADT, Dementia

LA JOLLA, CA—Research has been conflicting on whether androgen deprivation therapy is related to dementia. A research letter in JAMA Oncology pointed out that two studies reported a strong statistically significant association between ADT and... View Article


U.S. Medicine Recommends


More From rheumatology

Rheumatology

Target Lung Disease to Improve Rheumatoid Arthritis Survival

A recent VA study emphasized the importance of targeting comorbid lung disease to improve long-term outcomes in rheumatoid arthritis (RA).

Rheumatology

RA Fracture Risk Affected by Glucocorticoid Treatment

How much does systemic glucocorticoid exposure increase fracture among patients with newly-diagnosed inflammatory and immune-modulated conditions, including rheumatoid arthritis.

Rheumatology

Opioid Prescription Delays DMARD Initiation

What factors can cause delays in initiation of initial disease-modifying antirheumatic drug, or DMARD, in patients newly diagnosed with rheumatoid arthritis (RA)?

Rheumatology

Not Enough Veterans Get Folic Acid With Methotrexate

ATLANTA—The VA has rolled out a number of telehealth initiatives over the last years, with remote visits to dermatologists being offered to more and more veterans. But how well is the program working? A new... View Article

Rheumatology

PsA Patients Not at Increased Risk of Mortality, Except for Suicide

ATLANTA—The VA has rolled out a number of telehealth initiatives over the last years, with remote visits to dermatologists being offered to more and more veterans. But how well is the program working? A new... View Article

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up