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Vol. 17. Issue 5.
Pages 268-278 (May 2021)
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Vol. 17. Issue 5.
Pages 268-278 (May 2021)
Original Article
DOI: 10.1016/j.reumae.2019.06.003
Is obesity a predictor for lack of response to treatment in psoriatic arthritis? A systematic review
¿Es la obesidad un factor predictivo de falta de respuesta al tratamiento en la artritis psoriásica? Actualización de una revisión sistemática
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Jordi Gratacósa, Eva Galíndezb, Teresa Otónc,
Corresponding author
teresa.oton@inmusc.eu

Corresponding author.
a Servicio de Reumatología, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
b Servicio de Reumatología, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain
c Instituto de Salud Musculoesquelética, Madrid, Spain
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Tables (2)
Table 1. Table of evidence. Description of included studies which analyse the association of obesity with response.
Table 2. Results from individual studies on the association between obesity and efficacy of psoriatic arthritis treatments.
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Additional material (3)
Abstract
Objectives

To update the study of the association between obesity and treatment response in psoriatic arthritis.

Methods

Updating a systematic review of clinical trials, prospective or retrospective longitudinal studies and case–control studies in psoriatic arthritis in which obesity was assessed as a predictor of efficacy or toxicity. Risks of bias were assessed with validated scales. A meta-analysis of the results of studies with similar outcome variables and weight measurements was performed.

Results

Twenty-one studies were included (6 review of clinical trials, 6 longitudinal studies, 7 registers and one case–control studie), with moderate quality. The risk of achieving an ACR20 response if weight100kg was estimated at OR=1.42 (1–2.08) and that of withdrawing treatment in an OR of 1.60 (95% CI: 1.34–1.92).

Conclusions

There seems to be a greater risk of withdrawal of treatment due to inefficacy and difficulty in achieving remission in patients with psoriatic arthritis if they are obese.

Keywords:
Obesity
Psoriatic arthritis
Therapeutic response
Predictive factors
Systematic review
Resumen
Objetivos

Actualizar el estudio de la asociación entre obesidad y respuesta al tratamiento en artritis psoriásica.

Métodos

Actualización de una revisión sistemática previa, incluyendo ensayos clínicos aleatorizados, estudios longitudinales y casos-control en artritis psoriásica en los que se evaluase obesidad como predictor de eficacia o toxicidad. Los riesgos de sesgos se evaluaron con escalas validadas. Se realizó metaanálisis de los resultados de estudios con variables de desenlace y medidas del peso similares.

Resultados

Se incluyeron 21 estudios (6 ensayos clínicos aleatorizados, 6 estudios longitudinales, 7 registros y un caso-control), de calidad en general moderada. El riesgo de no respuesta ACR20 si el peso es100kg se estimó en OR=1.42 (1-2.08) y el de retirar el tratamiento en una OR de 1.60 (IC 95%: 1.34-1.92).

Conclusiones

Parece existir un mayor riesgo de retirada del tratamiento por ineficacia y dificultad para conseguir remisión en pacientes con artritis psoriásica si son obesos.

Palabras clave:
Obesidad
Artritis psoriásica
Respuesta terapéutica
Toxicidad
Factores predictivos
Revisión sistemática

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