The effects of obesity and smoking on the response to treatment in patients with rheumatoid arthritis (RA) was assessed in a study titled “Body mass index is an independent risk factor for not achieving sustained remission in early rheumatoid arthritis: results from the CATCH observational study,” presented at the EULAR Congress 2016 June 8-11 in London.

Affecting 0.3 to 1 percent of the world’s population — mostly women, RA is a condition where the body’s immune system attacks healthy cells, causing inflammation and pain in the joints, connective tissues, muscle, fibrous tissue, and tendons.

Drugs used to treat RA include disease-modifying agents and anti-inflammatory medications. The goal of treatment in RA patients is not to cure but to eliminate disease activity, causing remission. Nevertheless, many patients are incapable of accomplishing or maintaining remission status within a decade after the onset of symptoms. This has a lot to do with lifestyle factors, such as obesity and smoking, that may influence response to therapy.

In this study, the researchers investigated the effect of body weight and smoking on disease remission in patients with early RA in the first three years after diagnosis.

A total of 1,008 patients enrolled in the Canadian Early Arthritis Cohort (CATCH) study were followed for three years. The parameters related to disease activity, utilized treatments, and corresponding outcomes were evaluated at each visit.

The statistics indicated that of the enrolled patients, 50 percent of the men and 33 percent of women were overweight; 33 percent of men and 33 percent of women were obese; and 20 percent of men and 15 percent of women have smoked tobacco.

After adjusting the parameters related to age, race, baseline disability, pain, and early use of methotrexate, the results suggested that smoking and obesity significantly reduce the response to treatment. As a result, both men and women RA patients were unable to maintain sustained remission of their disease activity.

The researchers concluded that encouraging patients to maintain a healthy weight and a smoke-free lifestyle enhance their chances to react well to treatment and accomplish disease-free symptoms after therapy.

“Despite the high prevalence of excess body weight and smoking among RA patients, relatively little is known about whether and to what extent these modifiable lifestyle factors impact the likelihood of achieving sustained remission,” said study investigator Dr. Susan Bartlett from McGill University in Montreal, Canada, in a press release.

“Our findings show that not smoking and a healthy body weight – lifestyle factors which can be modified by patients – can have a significant impact on becoming symptom-free,” she said.