Obesity Weighs on Spondyloarthropathy Outcomes

November 22, 2017

Patients experience higher disease activity, lower quality of life, and worse physical functioning.

Patients with spondyloarthropathy who are obese experience higher disease activity, lower quality of life, and worse physical functioning than those who are of normal weight.

Obese patients with spondyloarthropathy tend to be older and have considerably more comorbidities, such as high blood pressure and elevated lipid levels, than do their normal weight counterparts.

Obesity is correlated directly with high disease activity scores in axial spondyloarthritis.

Although obesity is a global health concern, little evidence has been collected about how it affects patients who have axial spondyloarthritis. Dr Gillian Fitzgerald and fellow researchers in Dublin said they consider obesity to be one of the largest public health problems of the 21st century.

Because the limited research looking at spondyloarthritis and patient weight indicates that outcomes may be worse in obese patients, the authors sought to clarify the relationship in their study, which they presented at the ACR/ARHP Annual Meeting in San Diego.

The study
The authors conducted a cohort study using the Ankylosing Spondylitis Registry of Ireland. At the time of this report, 683 patients with axial spondyloarthropathy were enrolled; 77% were male and 23% female (average age, 45.9 years; mean disease duration, 19 years); 1.1% of subjects were underweight, 31.6% were of normal weight, 38.9% were overweight, and 28.4 % were obese.

The results
• Patients who were obese tended to be older and have hypertension and hyperlipidemia.

• Spinal mobility, quality of life, and physical function were reported as lower for obese patients with spondyloarthropathy.

• Obese patients with axial spondyloarthropathy smoked less than normal weight patients.

Implications for physicians
• Physicians should include weight reduction counseling as a part of their treatment plan for axial patients with spondyloarthropathy who are overweight or obese.

• Obesity is an independent risk factor for high disease activity and poor function in axial spondyloarthropathy and as such should be treated with equal dedication to anti-inflammatory therapy.

“When devising treatment plans for axial spondyloarthropathy patients, this study provides rheumatologists with a strong rationale to include strategies to actively control weight,” the authors stated in a press release.

References:

American College of Rheumatology Press Release. “New Data Released on Relationship Between Obesity and Spondyloarthropathy Outcomes.” November 4, 2017.

Fitzgerald G, Gallagher P, Sullivan C, et al. “Obese Axial Spondyloarthropathy Patients Have Worse Disease Outcomes.” Abstract Number 2508. 2017 ACR/ARHP Annual Meeting; San Diego.