title: Body mass index and response to tocilizumab in rheumatoid arthritis: a real life study.
abstract: Several studies have suggested that obesity could have a negative effect on response to anti-tumor necrosis factor α (anti-TNFα) in rheumatoid arthritis (RA). Little is known about the impact of body mass index (BMI) on other biologic agents. We aimed to evaluate the effect of BMI on response to tocilizumab (TCZ) in RA. RA patients treated with TCZ were included in this multicenter retrospective study. BMI was calculated at the initiation of treatment. After 6 months of treatment, change from baseline in DAS28, pain on a visual analog scale, erythrocyte sedimentation rate and C-reactive protein level, and tender and swollen joints were analyzed. The primary endpoint was decrease in DAS28 ≥ 1.2. Secondary outcomes were good response and remission by EULAR criteria. At baseline, among 115 RA patients included, the median (interquartile range) BMI was 25.4 (22.0-28.8) kg/m(2). The number of patients with normal weight, overweight, and obesity was 53 (46 %), 37 (32 %), and 25 (22 %), respectively. Baseline characteristics did not differ between the three subgroups of BMI. The median BMI did not differ between responders and non-responders for DAS28 decrease ≥1.2 (25.7 [22.1-29.9] vs 24.9 [22.0-27.1], P = 0.38), EULAR good response (25.9 [22.8-30.0] vs 25.4 [22.0-28.4], P = 0.61), and remission (25.1 [22.5-28.6] vs 25.4 [22.0-28.9], P = 0.76). BMI did not affect the response to TCZ in RA. If confirmed, these results could be helpful for the selection of a biologic agent in obese RA patients.
authors.affiliation: CHU Bichat Claude Bernard, Service de Rhumatologie, Université Paris Diderot, Hôpital Bichat, AP-HP, 46 rue Henri Huchard, 75018, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Gardette
authors.affiliation: CHU Bichat Claude Bernard, Service de Rhumatologie, Université Paris Diderot, Hôpital Bichat, AP-HP, 46 rue Henri Huchard, 75018, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Ottaviani
authors.affiliation: CHU Saint Antoine, Service de Rhumatologie, DHU i2B and Inserm UMRS_938, Université Pierre et Marie Curie, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Sellam
authors.affiliation: CHU Saint Antoine, Service de Rhumatologie, DHU i2B and Inserm UMRS_938, Université Pierre et Marie Curie, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Berenbaum
authors.affiliation: Inserm, UMR-S 606, CHU Lariboisière, Service de Rhumatologie, Université Paris Diderot, 2 rue Ambroise Paré, 75010, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Lioté
authors.affiliation: Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France.|Service de physiologie exploration fonctionnelle musculaire, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67098, Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Meyer
authors.affiliation: Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France.
authors.forename: J
authors.initials: J
authors.lastname: Sibilia
authors.affiliation: CHU La Pitié Salpétrière, Service de Rhumatologie, Université Pierre et Marie Curie, 47-83 boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Fautrel
authors.affiliation: CHU Bichat Claude Bernard, Service de Rhumatologie, Université Paris Diderot, Hôpital Bichat, AP-HP, 46 rue Henri Huchard, 75018, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Palazzo
authors.affiliation: CHU Bichat Claude Bernard, Service de Rhumatologie, Université Paris Diderot, Hôpital Bichat, AP-HP, 46 rue Henri Huchard, 75018, Paris, France. philippe.dieude@bch.aphp.fr.|Inserm, U1149, CNRS-ERL8252, Université Paris Diderot, 46 rue Henri Huchard, 75018, Paris, France. philippe.dieude@bch.aphp.fr.
authors.forename: P
authors.initials: P
authors.lastname: Dieudé
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001799:Blood Sedimentation; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight; D012074:Remission Induction; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; C502936:tocilizumab
keywords: Obesity; Rheumatoid arthritis; Tocilizumab