Obesity Is Associated With Worse Disease Activity Among Individuals With PsA on Biologic Therapy

Body mass index (BMI) is independently associated with psoriatic arthritis (PsA) disease activity and with patient-reported impact of disease and disability among individuals with PsA who receive biologic treatment, according to results of the PsABio study presented at the Annual European Congress of Rheumatology.

Obesity is associated with poor therapeutic response and higher treatment discontinuation rates among individuals with PsA who receive treatment with tumor necrosis factor (TNF) inhibitors. No data are available for other biologics.


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To investigate the impact of high BMI and obesity on PsA disease activity and other variables among individuals who receive biologic treatment, the researchers evaluated data on 917 participants from the PsABio study, an ongoing observational study that includes participants with PsA from 8 European countries.

All participants were beginning treatment with either a biologic (ustekinumab; n=450) or a TNF inhibitor (n=467).

At baseline, the researchers recorded the participants’ BMI, disease activity, and any presence or history of cardiovascular disease or metabolic equivalent. The participants’ disability and perceived disease impact were also recorded. 

All data were adjusted for age, sex, smoking, body surface area, C-reactive protein level, disease duration, and biologic treatment.

At baseline, the mean BMI among 827 of the participants was 28.1 kg/m2 (standard deviation, 5.8 kg/m2). Of these, 40.0% of participants were classified as being overweight and 30.4% were classified as having obesity.

The researchers determined that obesity was linked to worse PsA outcomes. Additionally, there was an association between higher BMI and more severe disease.

Higher BMI was also deemed to be independently linked to higher score on the clinical Disease Activity Index for PsA, higher patient-perceived disease impact, and higher disability.

“These results emphasize the need for lifestyle-directed approaches in PsA, such as overweight management in parallel with joint- and skin-focused treatment,” the researchers concluded.

—Colleen Murphy


Siebert S, Bergmans P, de Vlam K, et al. 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 [EULAR OP0007]. Ann Rheum Dis. 2019;78(suppl2):A69. http://scientific.sparx-ip.net/archiveeular/?c=a&view=1&searchfor=OP0007%20&item=2019OP0007. Accessed June 18, 2019.