Dynamics of body mass index and visceral adiposity index in patients with rheumatoid arthritis treated with tofacitinib
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The increase in cardiovascular risk in patients with rheumatoid arthritis (RA) compared with the general population is due to the combined effect of traditional risk factors for cardiovascular diseases, metabolic disorders, systemic inflammation, and side effects of antirheumatic drugs. Tofacitinib (TOFA) is an oral reversible inhibitor of janus kinases for the treatment of RA with proven efficacy and good tolerability, but its effects on body weight and metabolic profile need to be clarified. We investigated the effects of TOFA on body mass index (BMI) and visceral adiposity index (VAI) in RA patients. Thirty-one consecutive patients with active RA and starting new treatment with TOFA were included in a prospective 1 year follow-up observational study of cardiovascular effects of TOFA treatment. Weight, height, waist circumference, BMI, blood pressure, lipid profile, fasting glucose and VAI were measured at baseline and 12 months of treatment. Median weight gain was 3 kg (4.2%) after 1 year of TOFA. 23 (74%) patients suffered from a weight gain, and 6 (26%) out of them from a weight increment of 10% or more. Patients with lower BMI (p = 0.024) and higher baseline DAS28 [ESR] (p = 0.017) have the risk of an increase in BMI > 5% during TOFA treatment in a multivariate analysis. A decrease in VAI after 12 months was recorded. Weight increment and improvement of VAI are frequent on TOFA treatment. BMI dynamics associated with higher disease activity at baseline and lower baseline BMI.
KeywordsRheumatoid arthritis Tofacitinib Body mass index Visceral adiposity index
We would like to thank Elena L. Luchikhina and Dmitry E. Karateev for contributing to data collection and sharing additional data on the study.
DSN and EVU contributed to the conception and design of the study, data collection and analysis, manuscript writing and final approval of the manuscript. IGK, ASM, NVD and EIM contributed to data collection and analysis, critical revision and final approval of the manuscript. TVP made substantial contributions to the conception and design, revision of draft manuscript and approval of the final version to be published. All authors read and approved the final version of the manuscript.
There was no targeted funding relevant to this article Pfizer was not involved in the conduct of the study, the data analysis, manuscript preparation, the writing of the manuscript or the decision to submit the manuscript.
Conflict of interest
There are no potential conflicts of interest relevant to this article.
The research involved human participants.
All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol had been approved by the local ethics committee in V.A. Nasonova Research Institute of Rheumatology (protocol #4, 11th of December 2014).
Informed consent was obtained from all individual participants included in the study.
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