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Does Weight Affect Response to Biologic?

Obesity does not appear to affect clinical response to subcutaneous abatacept (Orencia) among patients with psoriatic arthritis (PsA), according to the findings of a recent study.

In the post hoc analysis, the researchers assessed data of participants with baseline body mass index (BMI) enrolled in the phase 3 Active Psoriatic Arthritis Randomized Trial. Participants were randomized to weekly subcutaneous 125 mg abatacept (n=212) or placebo (n=210) for 24 weeks.
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Main outcomes included the proportion of participants who achieved 20% improvement on the American College of Rheumatology criteria, Disease Activity Score in 28 joints (DAS28 (C reactive protein [CRP]) of 3.6 or less and less than 2.6, Health Assessment Questionnaire-Disability Index reduction from baseline score of 0.35 or less, and radiographic non-progression. These responses were stratified by baseline BMI and compared in univariate and multivariate models.

Among participants in the abatacept and placebo group, 15% and 19% were underweight/normal weight, 36% and 27% were overweight, and 49% and 54% were obese, respectively.

The researchers found no significant differences for any outcome measure at week 24 between participants in the overweight and obese subgroups and those in the underweight/normal subgroup after adjusting for baseline characteristics.

However, participants in the placebo group who were obese were significantly less likely to achieve less than 2.6 score on DAS28 at week 24 compared with those who were underweight or normal weight (odds ratio 0.26; 95% CI, 0.08 to 0.87).

“BMI does not impact clinical or radiographic response to [subcutaneous] abatacept in patients with PsA,” the researchers concluded.

Reference

McInnes IB, Ferraccioli G, D'Agostino MA, et al. Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial [published online May 30, 2019]. RMD Open. doi:10.1136/rmdopen-2019-000934

 

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