title: Body mass index and response to abatacept in rheumatoid arthritis.
abstract: BACKGROUND
  Previous studies suggested that obesity could negatively affect the response to antitumour necrosis factor-α (TNFα) agents in rheumatoid arthritis (RA). However, data are lacking on whether obesity affects the response to abatacept (ABA). We aimed to determine whether body mass index (BMI) affects the response to ABA in RA.
  
  
  METHODS
  In this multicenter retrospective study, we included RA patients who received ABA. 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, tender and swollen joint count were analysed. The primary endpoint was decrease in DAS28 ≥ 1·2. Secondary outcomes were good response and remission by EULAR criteria.
  
  
  RESULTS
  At baseline, among 141 RA patients included, the median [interquartile range] BMI was 26·0 [22·9-30·8] kg/m². The number of patients with normal weight, overweight and obesity was 64 (45·4%), 38 (27%) and 39 (27·6%), respectively. Baseline characteristics did not differ among the three BMI subgroups. Univariate analysis revealed no difference in BMI between responders and nonresponders: DAS28 decrease ≥ 1·2 (25·0 [23·4-31·3] vs. 26·3 [22·9-30·2], P = 0·95), EULAR good response (26·4 [23·5-30·9] vs. 26·0 [22·9-30·6], P = 0·96) and remission (26·7 [21·7-30·3] vs. 26·0 [23·0-30·1], P = 0·83).
  
  
  CONCLUSIONS
  In our real-life study, BMI did not affect the response to ABA in RA. If confirmed, these results suggest that obesity is not a limitation of ABA use in RA.
authors.affiliation: Sorbonne Paris Cité, Université Paris Diderot, Paris, France.|Service de Rhumatologie, Assistance Publique - Hôpitaux de Paris (APHP), Hôpital Bichat, Paris, France.
authors.forename: Anais
authors.initials: A
authors.lastname: Gardette
authors.affiliation: Sorbonne Paris Cité, Université Paris Diderot, Paris, France.|Service de Rhumatologie, Assistance Publique - Hôpitaux de Paris (APHP), Hôpital Bichat, Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Ottaviani
authors.affiliation: Université Pierre et Marie Curie, Paris, France.|Service de Rhumatologie, DHU i2B and Inserm UMRS_938, APHP, Hôpital Saint-Antoine, Paris, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Sellam
authors.affiliation: Université Pierre et Marie Curie, Paris, France.|Service de Rhumatologie, DHU i2B and Inserm UMRS_938, APHP, Hôpital Saint-Antoine, Paris, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Berenbaum
authors.affiliation: UMR-S 1132, Inserm, Université Paris Diderot, Paris, France.|Service de Rhumatologie, APHP, Hôpital Lariboisière, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lioté
authors.affiliation: Université Pierre et Marie Curie, Paris, France.|Service de Rhumatologie, APHP, Hôpital La Pitié Salpétrière, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.affiliation: Sorbonne Paris Cité, Université Paris Diderot, Paris, France.|Service de Rhumatologie, Assistance Publique - Hôpitaux de Paris (APHP), Hôpital Bichat, Paris, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Palazzo
authors.affiliation: Service de Rhumatologie, Fédération de Médecine Translationnelle, Centre de Référence des Maladies Autoimmunes Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.|Service de Physiologie Exploration Fonctionnelle Musculaire, Fédération de Médecine Translationnelle, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Meyer
authors.affiliation: Service de Rhumatologie, Fédération de Médecine Translationnelle, Centre de Référence des Maladies Autoimmunes Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.affiliation: Sorbonne Paris Cité, Université Paris Diderot, Paris, France.|Service de Rhumatologie, Assistance Publique - Hôpitaux de Paris (APHP), Hôpital Bichat, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Dieudé
mesh_terms: D000069594:Abatacept / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D001799:Blood Sedimentation; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D010147:Pain Measurement; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D000069594:Abatacept; D002097:C-Reactive Protein
keywords: Abatacept; obesity; rheumatoid arthritis