AB0029 NO PREDICTIVE EFFECT OF OBESITY ON CLINICAL RESPONSE IN PATIENTS WITH RA AND SpA AFTER 3 YEARS OF BIOLOGIC DRUGS: A MULTICENTER STUDY
Authors: N. EL Ouardi, E. A. Houda, H. Zouaki, L. Taoubane, H. Elhani, K. El Marbouh, A. Majjad, H. Toufik, R. Niamane, I. Hmamouchi, R. Abouqal, F. Allali, R. Bahiri, I. El Bouchti, I. El Ghozlani, H. Hassikou, I. Linda, S. Janani, T. Harzy, A. El Maghraoui, A. Bezza
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Obesity is a comorbidity that plays a role in the development and severity of inflammatory joint diseases, including rheumatoid arthritis (RA), psoriatic arthritis and axial spondyloarthritis (SpA). The relationships between obesity and adipose tissue and the treatments given for inflammatory joint diseases are bidirectional. Indertstanding the impact of obesity on the response to biological disease-modifying antirheumatic drugs (bDMARDs) will be critical to choose appropriate use of therapies in obese RA and SpA patients. <h3>Objectives:</h3> The aim of this study was to determine the real influence of obesity in the therapeutic response to biological treatments in RA and SpA of RBSMR. <h3>Methods:</h3> We enrolled patients with RA and SpA treated with bDMARDs of a real setting utilizing a nationwide drug registry (RBSMR) for monitoring biologic therapies in RA and SpA diseases. Period of follow up was 3 years. Baseline BMI was classified as normal (BMI &lt; 30 kg/m2) or obese (BMI ≥ 30 kg/m2). Improvement of disease activity scores and achievement of the European League Against Rheumatism (EULAR) remission and good response were our measures of clinical improvement. The statistical analysis was performed using SPSS logiciel. <h3>Results:</h3> 202 RA and 163 SpA were analyzed. 46 RA and 30 SpA were bDMARD naïve. No differences were found when comparing baseline activity scores (DAS28 ESR, DAS28 CRP, BASDAI, ASDAS CRP) between obese and no obese RA and SpA patients. Rituximab was the main bDMARD used in both obese (63.6%) and no obese RA (58%). Adalimumab and etanercept were the bDMARDs mainly used in obese (36.4%) and no obese (33.3%) SpA patients respectively. After 3 years of follow-up, DAS28 scores significantly improved in both obese and no obese RA patients (DAS28 CRP: p&lt;0.001 for both obese and no obese patients/ DAS28 ESR: p=0.002 and p &lt;0.001 for obese and no obese patients respectively). No significant differences were found when comparing BASDAI scores between inclusion and 3 years in obese and no obese SpA (p=0.18 and p=0.07 respectively). At year 3, Prevalences of remission were higher in non obese RA (29.3% versus 13.6%) and non obese SpA patients (34.2% versus 14.3%). Obese patients achieved good response EULAR in 27.3% RA and 64.7% SpA. These differences were no statistically significant. <h3>Conclusion:</h3> Our results suggest that BMI is not a relevant predictor of response to bDMARDs in moroccan RA and SpA patients. Thus no personalized treatment strategy should be considered for obese patients. Specific studies using DEXA examining the direct impact of obesity, and, ideally, of fat mass, on the therapeutic response of recently licensed bDMARDs and tsDMARDs are required. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>