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首页> 外文期刊>Arthritis care & research >Obesity and reduction of the response rate to anti-tumor necrosis factor α in rheumatoid arthritis: An approach to a personalized medicine
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Obesity and reduction of the response rate to anti-tumor necrosis factor α in rheumatoid arthritis: An approach to a personalized medicine

机译：肥胖和类风湿关节炎中抗肿瘤坏死因子α的缓解率降低：一种个性化药物的方法

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Objective Obesity is a mild, long-lasting inflammatory disease and, as such, could increase the inflammatory burden of rheumatoid arthritis (RA). The study aim was to determine whether obesity represents a risk factor for a poor remission rate in RA patients requiring anti-tumor necrosis factor α (anti-TNFα) therapy for progressive and active disease despite treatment with methotrexate or other disease-modifying antirheumatic drugs. Methods Patients were identified from 15 outpatient clinics of university hospitals and hospitals in Italy taking part in the Gruppo Italiano di Studio sulle Early Arthritis network. Disease Activity Score in 28 joints (DAS28), body mass index (BMI; categorized as 25, 25-30, and 30 kg/m2), acute-phase reactants, IgM rheumatoid factor, and anti-cyclic citrullinated peptide antibody values were collected. DAS28 remission was defined as a score of 2.6 lasting for at least 3 months. Results Six hundred forty-one outpatients with longstanding RA receiving anti-TNFα blockers (adalimumab, n = 260; etanercept, n = 227; infliximab, n = 154), recruited from 2006-2009 and monitored for at least 12 months, were analyzed. The mean ± SD DAS28 at baseline was 5.6 ± 1.4. A BMI of 30 kg/m2 was recorded in 66 (10.3%) of 641 RA patients. After 12 months of anti-TNFα treatment, a DAS28 of 2.6 was noted in 15.2% of the obese subjects, in 30.4% of the patients with a BMI of 25-30 kg/m2, and in 32.9% of the patients with a BMI of 25 kg/m2 (P = 0.01). The lowest percentage of remission, which was statistically significant versus adalimumab and etanercept (P = 0.003), was observed with infliximab. Conclusion Obesity represents a risk factor for a poor remission rate in patients with longstanding RA treated with anti-TNFα agents. A personalized treatment plan might be a possible solution.
机译：目的肥胖是一种轻度，长期的炎症性疾病，因此，它可能会增加类风湿关节炎（RA）的炎症负担。该研究的目的是确定肥胖患者是否是需要抗肿瘤坏死因子α（抗TNFα）治疗进展性和活动性疾病的RA患者（尽管接受甲氨蝶呤或其他改变疾病的抗风湿药治疗）的缓解率低的危险因素。方法从意大利大学医院和意大利医院的15家门诊诊所中识别患者，这些患者参加了Gruppo Italiano di Studio sulle早期关节炎网络。 28个关节的疾病活动评分（DAS28），体重指数（BMI;分类为<25、25-30和> 30 kg / m2），急性期反应物，IgM类风湿因子和抗环瓜氨酸肽抗体值被收集。 DAS28缓解定义为持续至少3个月的<2.6分。结果分析了2006年至2009年招募的并监测了至少12个月的611例接受抗TNFα阻断剂的长期门诊患者（阿达木单抗（n = 260）;依那西普（n = 227）;英夫利昔单抗（n = 154）） 。基线时的平均值±SD DAS28为5.6±1.4。在641名RA患者中，有66名（10.3％）的BMI> 30 kg / m2。经过12个月的抗TNFα治疗，在15.2％的肥胖受试者，30.4％的BMI为25-30 kg / m2的患者以及32.9％的肥胖患者中DAS28 ＜2.6。 BMI <25 kg / m2（P = 0.01）。英夫利昔单抗观察到最低缓解率，与阿达木单抗和依那西普相比具有统计学意义（P = 0.003）。结论肥胖是长期接受抗TNFα药物治疗的RA患者缓解率低的危险因素。个性化的治疗计划可能是一种解决方案。

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