High Body Mass Index Linked to Poor Infliximab Response

Rheumatoid arthritis patients with high BMI have low response despite dosing for body weight

TUESDAY, Feb. 15 (HealthDay News) -- Patients suffering from rheumatoid arthritis (RA) who have a high body mass index (BMI) respond less well to infliximab, even when adjusting for disease activity and anti-citrullinated protein antibody status, according to a study published in the February issue of Arthritis & Rheumatism.

Ruth Klaasen, M.D., from the University of Amsterdam in the Netherlands, and colleagues studied 89 patients with active RA to determine whether BMI affects response to infliximab. BMI was calculated before the patients began treatment with infliximab. Patients were treated for 16 weeks and then had their disease activity assessed using the Disease Activity Score in 28 joints (DAS28).

The researchers found a positive correlation between the BMI and DAS28 at baseline. After correcting for baseline DAS28 with an analysis of covariance, the researchers identified a very significant, negative association between BMI and the absolute decrease in DAS28 after 16 weeks. This decrease was also seen when adjusting for anti-citrullinated protein antibodies.

"RA patients with a high BMI exhibited a diminished clinical response to infliximab treatment, despite drug dosing based on body weight. This finding suggests that adipose tissue could play a role in the pathophysiology of RA," the authors write.

One author disclosed financial relationships with several pharmaceutical companies, including Centocor and Schering-Plough.

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