ArticleRheumatology (Oxford, England)2020
Obesity reduces the real-world effectiveness of cytokine-targeted but not cell-targeted disease-modifying agents in rheumatoid arthritis.
Article in Rheumatology (Oxford, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 28 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Therapeutic approaches for difficult-to-treat rheumatoid arthritis: a systematic literature review of current evidence.RMD open · 2026Pooled it
- Pooled it
- Effects of IL-6 Signaling Pathway Inhibition on Weight and BMI: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2020Pooled it
- Trial
- Metabolic Complications in Autoimmune and Autoinflammatory Diseases: Pathophysiology, Clinical Implications, and Therapeutic Perspectives.Journal of clinical medicine · 2026Review
- Tocilizumab in German patients with RA: real-world evidence from the noninterventional studies ARATA and ICHIBAN.EULAR rheumatology open · 2026Review
- What to do when the first TNF inhibitor fails in rheumatoid arthritis: stratified expert recommendations from a scoping review and Delphi consensus.Therapeutic advances in musculoskeletal disease · 2026Article
- Association between C-reactive protein and hemoglobin in US rheumatoid arthritis patients based on NHANES data analysis.Scientific reports · 2025Article
- Update on tocilizumab in rheumatoid arthritis: a narrative review.Frontiers in immunology · 2025Review
- Body mass index stratification enables cytokine-based prediction of ACPA status and Power-Doppler disease activity in rheumatoid arthritis.Clinical rheumatology · 2024Article
- Lower body mass and lower adiposity are associated with differential responses to two treatment strategies for rheumatoid arthritis.Annals of the rheumatic diseases · 2024Article
- Impact of obesity on clinical outcomes and treatment continuation in rheumatoid arthritis patients receiving non-TNF-targeted therapies.Therapeutic advances in musculoskeletal disease · 2024Article
- The role of cGAS-STING signaling in rheumatoid arthritis: from pathogenesis to therapeutic targets.Frontiers in immunology · 2024Review
- Article
- [Gender-specific differences in the diagnosis and treatment of inflammatory rheumatic diseases].Innere Medizin (Heidelberg, Germany) · 2023Review
- Body mass index does not affect response of rituximab in patients with rheumatoid arthritis: results from the TURKBİO registry.Turkish journal of medical sciences · 2023Article
- [Celebrating 33 years of the DRFZ: Epidemiology and Health Services Research].Zeitschrift fur Rheumatologie · 2022Review
- [Latest findings from the RABBIT register].Zeitschrift fur Rheumatologie · 2022Review
- TNFi Cycling Versus Changing Mechanism of Action in TNFi-Experienced Patients: Result of the Corrona CERTAIN Comparative Effectiveness Study.ACR open rheumatology · 2022Article
- Managing inadequate response to initial anti-TNF therapy in rheumatoid arthritis: optimising treatment outcomes.Therapeutic advances in musculoskeletal disease · 2022Review
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe effectiveness of TNF inhibitors in RA has been shown to be affected by obesity. No such effect has been found for abatacept and rituximab, while for tocilizumab results are ambiguous. Additionally, it remains unresolved whether sex is an effect modifier for obesity. We investigated the impact of obesity on the drug effectiveness of conventional synthetic or biologic DMARDs, taking into account potential sex-specific differences.
methodsData from 10 593 RA patients included in the German observational cohort study Rheumatoid Arthritis: oBservation of BIologic Therapy (RABBIT) since 2009 were analysed. Patients had to have a BMI ≥18.5 kg/m2, at least one follow-up and 6 months of observation time. The influence of obesity on drug effectiveness was investigated by regression analysis, adjusting for potential confounders.
resultsObesity had a negative impact on improvement in the DAS with 28 joints using ESR as an inflammation marker of -0.15 (95% CI: -0.26; -0.04) units for women receiving conventional synthetic DMARDs, -0.22 (95% CI: -0.31; -0.12) units for women receiving TNF inhibitors, -0.22 (95% CI: -0.42; -0.03) units for women receiving tocilizumab and -0.41 (95% CI: -0.74; -0.07) units for men receiving tocilizumab. Overall, no negative obesity effects on the effectiveness of rituximab and abatacept were found.
conclusionObesity has a negative impact on the effectiveness of cytokine-targeted but not cell-targeted therapies in daily practice, affecting more outcomes and therapies in women than in men. Overall, no effects of obesity on treatment effectiveness were found for rituximab and abatacept.
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