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Association of body mass index on disease activity in axial spondyloarthritis: systematic review and meta-analysis.

Authors :
Liew JW
Huang IJ
Louden DN
Singh N
Gensler LS
Source :
RMD open [RMD Open] 2020 May; Vol. 6 (1).
Publication Year :
2020

Abstract

Objectives: In axial spondyloarthritis (axSpA), higher body mass index (BMI) is associated with worse outcomes including response to biologics. Further clarity is needed on whether BMI is associated with disease activity overall, independent of treatment response. We performed a systematic review and meta-analysis to assess the association between BMI and disease activity as reported by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) or Ankylosing Spondylitis Disease Activity Score (ASDAS) in axSpA.<br />Methods: We systematically searched for studies evaluating BMI and disease activity as the exposure and outcome of interest, respectively, in axSpA. Using random effects models, we estimated summary standardised mean differences (SMDs) and 95% CIs of BASDAI or ASDAS, comparing obese (BMI>30 kg/m <superscript>2</superscript> ) or overweight/obese (BMI>25 kg/m <superscript>2</superscript> ) individuals to those with normal BMI (18.5-24.9 kg/m <superscript>2</superscript> ).<br />Results: Twelve studies were included in the meta-analysis. Among all studies reporting the BASDAI at baseline, the pooled SMD of the BASDAI for those with an obese or overweight/obese BMI compared to a normal BMI was 0.38 (95% CI 0.21 to 0.55, I <superscript>2</superscript> =75.2%), indicating a significant association of higher BMI with higher BASDAI score. The pooled SMD of the ASDAS for those with an obese or overweight/obese BMI compared to a normal BMI was 0.40 (95% CI 0.27 to 0.54, I <superscript>2</superscript> =0%). Findings were robust across subgroup analyses.<br />Conclusion: These results demonstrate an association between an overweight/obese BMI and higher disease activity in studies of axSpA. Future longitudinal studies of BMI and disease activity should assess how this association changes over time.<br />Competing Interests: Competing interests: LSG: Consulting for AbbVie, GSK, Eli Lilly, Novartis, Pfizer and UCB (under $10 000); Grant/research support from UCB, Novartis, Pfizer; All others: None.<br /> (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Details

Language :
English
ISSN :
2056-5933
Volume :
6
Issue :
1
Database :
MEDLINE
Journal :
RMD open
Publication Type :
Academic Journal
Accession number :
32434828
Full Text :
https://doi.org/10.1136/rmdopen-2020-001225