SAT0328 Weight-loss improves disease activity in obese patients with psoriatic arthritis

Abstract

Background Obesity is over-represented in patients with psoriatic arthritis (PsA) and associated with increased risk of getting the disease, higher disease activity, poorer effect of treatment and in addition cardiovascular co-morbidity. Objectives The aim of this study was to determine the effects of weight-loss treatment on disease activity in patients with PsA and obesity Methods Patients with PsA (Caspar criteria) and obesity (body mass index BMI≥33 kg/m2) where recruited from three Rheumatology clinics in the Western Sweden. Weight-loss treatment with Very Low Energy liquid Diet (VLED), which comprises a daily energy intake of 640 kcal, was given during 12–16 weeks, depending on BMI. The first strict period was followed by a structured reintroduction of an energy restricted diet during 18 weeks. The treatment was given within the framework of a structured program including support and medical follow-up at the Obesity Unit at Sahlgrenska University Hospital.Treatment with DMARDs and biologics was held constant from 3 month before baseline until 6 months after baseline. The patients were assessed with 66/68 joints count, back-mobility tests, body surface area (BSA), questionnaires, ESR, CRP and BMI at baseline, 3 and 6 months. The number of patients reaching Psoriatic Arthritis Response Criteria (PsARC) and Minimal Disease Activity (MDA) was calculated. Results Totally 41 PsA patients, median age 54 (IQR 48–62) years, 63% women were included. The median weight-loss was 18.7 (IQR 14.6–26.5) kg. BMI decreased from median 35.2 (34.1–38.1) to 29.7 (26.2–31.5) kg/m2. A majority of the disease activity parameters improved significantly (Table). Totally 16 patients (39.0%) reached PsARC and the number of patients with MDA increased from n=12 (29%) to n=22 (54%), p<0.001 between baseline and the 6 months visit. Conclusions Weight-loss treatment with VLED had significant positive effects on disease activity in joints, entheses and skin in patients with PsA and obesity. Disclosure of Interest E. Klingberg Grant/research support from: The VLED used in this study was sponsored by Cambridge Weight Plan., A. Bilberg: None declared, S. Björkman: None declared, B. Eliasson: None declared, I. Larsson: None declaredView this table:View inline View popup