Obesity and its associations with clinical manifestations and disease burden of patients with spondyloarthritis: An ancillary study from the ASAS-PerSpA project

Mehmet Tuncay Duruöz; Sevtap Acer Kasman; Halise Hande Gezer; Clementina López-Medina; Maxime Dougados

doi:10.1016/j.semarthrit.2025.152904

Obesity and its associations with clinical manifestations and disease burden of patients with spondyloarthritis: An ancillary study from the ASAS-PerSpA project

Semin Arthritis Rheum. 2025 Dec 28:152904. doi: 10.1016/j.semarthrit.2025.152904. Online ahead of print.

Authors

Mehmet Tuncay Duruöz¹, Sevtap Acer Kasman², Halise Hande Gezer³, Clementina López-Medina⁴, Maxime Dougados⁵

Affiliations

¹ Rheumatology Division, Physical Medicine and Rehabilitation Department, Marmara University School of Medicine, Istanbul, Türkiye.
² Bahcesehir University, Faculty of Medicine, Medical Park Hospital, Rheumatology, Pendik, Istanbul, Türkiye.
³ Rheumatology Division, Physical Medicine and Rehabilitation Department, Marmara University School of Medicine, Istanbul, Türkiye. Electronic address: hande_snc@hotmail.com.
⁴ Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; ECAMO, INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris, Paris, France; Rheumatology Department, Reina Sofia University Hospital, IMIBIC, University of Córdoba, Córdoba, Spain.
⁵ Université de Paris, Centre de recherche épidémiologie et bio statistique de Sorbonne Paris Cité, Service de rhumatologie, APHP, Hôspital Cochin, F-75014 Paris, France. Electronic address: maxime.dougados@aphp.fr.

PMID: 41513543
DOI: 10.1016/j.semarthrit.2025.152904

Abstract

Objective: This study aims to explore the relationship of obesity with clinical manifestations and disease burden including biologic/targeted DMARD (btDMARD), SpA-related surgery, work productivity loss, and patient-reported health status.

Methods: An ancillary analysis of the Assessment of Spondyloarthritis International Society PerSpA (PERipheral involvement in SpA) cross-sectional study from 24 participating countries. The PerSpA study included the data of clinical characteristics, btDMARD use and history (number of btDMARD kinds ever-prescribed, number of discontinuation, and the reasons for discontinuation), SpA-related surgery, work productivity and activity impairment, and patient-reported health status (ASAS Health Index, Bath Ankylosing Spondylitis Functional Index, and global wellbeing). Patients were divided into three groups according to the current BMI (BMI_c) and comparisons between the obese patients, overweights, and normal weights were performed for the above-mentioned parameters. The study population was also divided into different three groups according to their 20-year-old BMI (BMI_20y) and they were compared in itself.

Results: Among the 4449 patients, 34.6% were overweight, 21% obese, and 44.4% normal-weight. Obese/overweight patients had a higher btDMARD burden, btDMARD inefficacy, work impairment, and worse patient-reported health (p < 0.05 for all). The differences were preserved in comparisons adjusted for age, gender, and smoking. When the patients were compared according to their BMI_20y, similar differences were also found.

Conclusions: Obesity invites a biological therapy burden, work productivity loss, and worse patient-reported health status in patients with SpA.

Keywords: Biological therapy; Burden; Obesity; Overweight; Spondyloarthritis.