title: Body mass index and response to infliximab in rheumatoid arthritis.
abstract: OBJECTIVE
  Excess adipose tissue in obese individuals may have immunomodulating properties and pharmacokinetics consequences. Previous studies have suggested that obesity could negatively affect the response to anti-TNF-α agents, notably infliximab (IFX). We aimed to determine whether body mass index (BMI) is involved in the response to IFX in rheumatoid arthritis (RA).
  
  
  METHODS
  We retrospectively examined data for 76 RA patients receiving IFX. BMI was calculated before treatment, and change from baseline in DAS28, pain on a visual analog scale, erythrocyte sedimentation rate, C-reactive protein level, tender and swollen joint count was analysed at 6 months after treatment. The primary outcome was decrease in DAS28 ≥1.2. Secondary outcomes were good response and remission according to EULAR.
  
  
  RESULTS
  At baseline, the median [interquartile range] BMI was 26.6 [22.6-30.6] kg/m2. The number of patients with normal weight, overweight and obesity was 25, 29 and 22. In multivariable analyses, IFX treated patients with lower BMI showed a more frequent DAS28 decrease ≥1.2 (25.5 [22.3-28.3] vs. 28.0 [23.2-32.5], p=0.02, odds ratio [OR] 0.88 [95% confidence interval 0.79-0.98]), EULAR good response (25.3 [21.9-27.5] vs. 27.5 [24.3-31.2], p=0.03, OR 0.87 [0.76-0.99]) and EULAR remission, although not significant (25.3 [21.9-26.4] vs. 27.5 [23.2-30.9], p=0.14, OR 0.88 [0.75-1.04]).
  
  
  CONCLUSIONS
  Obesity may negatively influence the response to IFX in RA. These data could help physicians to choose biologic agents for obese RA patients.
authors.affiliation: Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Ottaviani
authors.affiliation: Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Anais
authors.initials: A
authors.lastname: Gardette
authors.affiliation: Département d'Epidémiologie Biostatistique et Recherche Clinique, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Tubach
authors.affiliation: Département d'Epidémiologie Biostatistique et Recherche Clinique, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
authors.forename: Carine
authors.initials: C
authors.lastname: Roy
authors.affiliation: Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Palazzo
authors.affiliation: Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Gill
authors.affiliation: Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Meyer
authors.affiliation: Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Dieudé
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage; D018771:Arthralgia / Q000175:diagnosis* / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D001799:Blood Sedimentation; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D010147:Pain Measurement; D062072:Patient Acuity; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000069285:Infliximab