The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis.
The Impact of Obesity on Disease Activity and Treatment Response in Rheumatoid Arthritis.
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DOI：
10.1007/s11926-020-00933-4
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发表时间：
2020-08-01
影响因子：
5
通讯作者：
Baker JF
中科院分区：
文献类型：
--
作者：
Poudel D;George MD;Baker JF
越来越多的研究表明，肥胖的类风湿性关节炎（RA）患者的疾病结局和对治疗的反应可能不同。本综述的目的是检查最新的文献，重点是肥胖对RA疾病活动性和治疗结果评估的影响。肥胖在类风湿关节炎患者中很常见，对患者的症状和预后有很大影响。肥胖与慢性疼痛和阿片类药物使用率较高、炎症标志物升高和体格检查结果不可靠相关，使疾病活动和治疗反应的评估更具挑战性。尽管临床疾病活动性似乎更差，但越来越多的证据表明，患有RA的肥胖患者随着时间的推移，影像学炎症较少，放射学进展率较低。肥胖是否影响特定疗法的有效性仍存在争议。肥胖是非常常见的，与RA患者中更严重的症状和更高的残疾率相关。虽然经常观察到肥胖RA患者的临床疾病活动性较高，但仍不清楚这种情况下较差的治疗应答率是否与治疗疗效降低有关，或者是否是准确评估疾病的偏倚所致。
A growing number of studies have suggested that disease outcomes and response to therapy may be different in patients with rheumatoid arthritis (RA) who are obese. The goal of this review is to examine the most recent literature, with a focus on the impact of obesity on the assessment of disease activity and treatment outcomes in RA. Obesity is common in patients with RA and can have a substantial impact on patient symptoms and outcomes. Obesity is associated with higher rates of chronic pain and opiate use, elevated inflammatory markers, and less reliable physical exam findings, making assessment of disease activity and treatment response more challenging. Despite seemingly worse clinical disease activity, evidence has accumulated demonstrating that obese patients with RA have less inflammation by imaging and lower rates of radiographic progression over time. Whether obesity influences the effectiveness of specific therapies remains controversial. Obesity is very common and is associated with more severe symptoms and higher rates of disability among RA patients. While clinical disease activity is frequently observed to be higher in obese patients with RA, it remains unclear whether poorer treatment response rates in this setting are related to reduced efficacy of therapies or are an artifact of biases in the accurate assessment of the disease.
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影响因子：
2.3
作者：
Bauer EM;Ben-Artzi A;Duffy EL;Elashoff DA;Vangala SS;Fitzgerald J;Ranganath VK
通讯作者：
Ranganath VK
影响因子：
4.7
作者：
George, Michael D.;Giles, Jon T.;Baker, Joshua F.
通讯作者：
Baker, Joshua F.
影响因子：
4.7
作者：
Messier, Stephen P.;Resnik, Allison E.;Loeser, Richard F.
通讯作者：
Loeser, Richard F.
影响因子：
6.9
作者：
Maglio, Cristina;Peltonen, Markku;Carlsson, Lena M. S.
通讯作者：
Carlsson, Lena M. S.
影响因子：
4.7
作者：
Baker JF;England BR;Mikuls TR;Sayles H;Cannon GW;Sauer BC;George MD;Caplan L;Michaud K
通讯作者：
Michaud K