OP0007 HIGH BODY MASS INDEX (BMI) IN PSORIATIC ARTHRITIS (PSA) IS ASSOCIATED WITH HIGHER DISEASE ACTIVITY IN JOINTS AND SKIN, IMPAIRED QUALITY OF LIFE AND MORE DISABILITY: RESULTS FROM THE PSABIO STUDY
Authors: Stefan Siebert, Paul Bergmans, Kurt de Vlam, Elisa Gremese, Beatriz Joven-Ibáñez, Tatiana Korotaeva, Wim Noel, M.T. Nurmohamed, Petros Sfikakis, Ana Laiz, Pavel Smirnov, Elke Theander, Josef S. Smolen, Laure Gossec
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The link between obesity and disease activity in PsA is unclear. Obesity has been associated with a poorer therapeutic response and higher treatment discontinuation rates in patients with PsA being treated with tumour necrosis factor inhibitors (TNFi). Recent data confirm the favourable effect of weight reduction on these factors. There are no data available for other biologics. <h3>Objectives</h3> To investigate the relationship between baseline overweight/obesity and disease activity, patient-reported outcomes and disability, in a large real-world cohort of patients with PsA starting biologic treatment with either ustekinumab (UST) or TNFi. <h3>Methods</h3> The PsABio study (ClinicalTrials.gov: NCT02627768) is an ongoing observational study evaluating efficacy, tolerability and persistence of 1<sup>st</sup>, 2<sup>nd</sup>- and 3<sup>rd</sup>-line UST or TNFi in PsA in 8 European countries<sup>1</sup> when introduced as part of standard clinical care. Baseline data of the study population were collected and analysed for BMI, disease activity (cDAPSA, psoriasis BSA), patient-perceived impact (PsAID-12), disability (HAQ-DI) and presence or history of CVD/MET. Descriptive statistics on available data and 3 exploratory multiple regression models are shown, to investigate the relationship of cDAPSA, PsAID-12 and HAQ-DI (dependent variables) with BMI, adjusted for age, sex, smoking, BSA, CRP, disease duration and biologic treatment. <h3>Results</h3> In all, 917 patients were included, starting either UST (n=450) or TNFi (n=467): mean (SD) age 49.7 (12.5) years, 55.5% female. The mean (SD) baseline BMI (N=827) was 28.1 (5.8) kg/m<sup>2</sup>, with 40.0% and 30.4% in BMI categories overweight (&gt;25–30) and obese (&gt;30), respectively. In univariate analyses, obesity was linked to worse outcomes (Table 1). More severe disease was associated with higher BMI (Table 2). In multiple regression modelling, higher BMI was independently linked to higher cDAPSA (BMI: β=0.09 p=0.026); to higher patient-perceived disease impact measured by PsAID-12 (BMI: β=0.16, p&lt;0.0001) and to higher disability measured by HAQ-DI (BMI: β=0.21, p&lt;0.0001). <h3>Conclusion</h3> This multi-country routine-care PsA cohort of patients in need of biologic treatment confirms the high prevalence of overweight/obesity and indicates an independent association between high BMI and disease activity as well as patient-reported impact of disease and disability. These results emphasize the need for lifestyle-directed approaches in PsA, such as overweight management in parallel with joint- and skin-focused treatment. <h3>Reference</h3> [1] Gossec L, et al. Ann Rheum Dis. 2018;77(Suppl):A1033. <h3>Acknowledgement</h3> This study was sponsored by Janssen <h3>Disclosure of Interests</h3> Stefan Siebert Grant/research support from: AbbVie, Novartis, Pfizer, Janssen, BMS, Celgene, UCB, and Boehringer Ingelheim, Consultant for: AbbVie, UCB, Pfizer, Janssen, Boehringer Ingelheim, Celgene, and Novartis, Speakers bureau: AbbVie, UCB, Pfizer, Janssen, Boehringer Ingelheim, Celgene, and Novartis, Paul Bergmans Shareholder of: Johnson &amp; Johnson, Employee of: Janssen, Kurt de Vlam Consultant for: Pfizer Inc, Consultant for: Johnson &amp; Johnson, Elisa Gremese Consultant for: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Sanofi, UCB, Roche, and Pfizer, Speakers bureau: BMS, Speakers bureau: Roche, Speakers bureau: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Sanofi, UCB, Roche, and Pfizer, Beatriz Joven-Ibáñez Speakers bureau: Celgene, Novartis, MSD, Pfizer, AbbVie, and Janssen, Tatiana Korotaeva Consultant for: Pfizer, MSD, Novartis, AbbVie, Celgene, Biocad, Janssen, UCB, Lilly and Novartis-Sandoz, Speakers bureau: Pfizer, MSD, Novartis, AbbVie, Celgene, Biocad, Janssen, UCB, Lilly and Novartis-Sandoz, Wim Noel Employee of: Janssen, M.T. Nurmohamed Grant/research support from: Pfizer, AbbVie, Roche, BMS, MSD, Mundipharma, UCB, Janssen, Menarini, Lilly, Sanofi, and Celgene., Grant/research support from: Pfizer, Abbvie, Roche, BMS, MSD, Mundipharma, UCB, Janssen, Menarini, Eli Lilly, Celgene &amp; Sanofi, Consultant for: Pfizer, AbbVie, Roche, BMS, MSD, Mundipharma, UCB, Janssen, Menarini, Lilly, Sanofi, and Celgene., Speakers bureau: Pfizer, AbbVie, Roche, BMS, MSD, Mundipharma, UCB, Janssen, Menarini, Lilly, Sanofi, and Celgene., Speakers bureau: Pfizer, Abbvie, Roche, BMS, MSD, Mundipharma, UCB, Janssen, Menarini, Eli Lilly, Celgene &amp; Sanofi, Petros Sfikakis: None declared, Ana Laiz Consultant for: Lilly, Novartis, AbbVvie, MSD, UCB and Janssen, Speakers bureau: Lilly, Novartis, Abvvie, MSD, UCB and Janssen, Pavel Smirnov Employee of: Janssen, Elke Theander Employee of: Janssen, Josef S. Smolen Grant/research support from: AbbVie, Eli Lilly, Janssen, MSD, Pfizer Inc, Roche, Consultant for: AbbVie, Amgen, AstraZeneca, Astro, Celgene, Celtrion, Eli Lilly, GlaxoSmithKline, ILTOO, Janssen, Medimmune, MSD, Novartis-Sandoz, Pfizer Inc, Roche, Samsung, Sanofi, UCB, Speakers bureau: AbbVie, Amgen, AstraZeneca, Astro, Celgene, Celtrion, Eli Lilly, GlaxoSmithKline, ILTOO, Janssen, Medimmune, MSD, Novartis-Sandoz, Pfizer Inc, Roche, Samsung, Sanofi, UCB, Laure Gossec Grant/research support from: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis-Sandoz, Pfizer, Sanofi, and UCB, Consultant for: AbbVie, Biogen, BMS, Celgene, Janssen, Lilly, MSD, Nordic Pharma, Novartis-Sandoz, Pfizer, Roche, Sanofi, and UCB, Consultant for: L Gossec has received honoraria from Celgene as investigator for this study