E139 Disease burden and comorbidities in patients with psoriatic arthritis and concomitant obesity - a pooled analysis of three clinical trials

Abstract Background/Aims The relationship between psoriatic arthritis (PsA) and obesity is complex: obesity can increase the risk of developing PsA, whereas weight loss interventions in patients with PsA may lead to improved disease activity and treatment response. Methods This analysis pooled data from SPIRIT-P1, SPIRIT-P2, and SPIRIT-H2H clinical trials with biologic-naive and biologic-experienced adult patients with active PsA. Patient characteristics, disease burden, and comorbidities at baseline (BL) were analysed across body mass index (BMI, kg/m2) groups: 25 (normal), ≥25 to 30 (overweight), and ≥30 (obesity). The non-parametric Mann-Whitney U test was used to statistically compare differences between BMI groups, with p-value ≤0.05 signalling statistical differences. Results Among 1284 patients, 42.6% had a BMI of ≥ 30 (obesity). Patients living with obesity had higher mean (standard deviation) tender joint counts (23.0 14.7), swollen joint counts (12.1 9.2), Disease Activity Index in PsA (49.123.0), Disease Activity Score 28-CRP (5.1 1.0), Fatigue Numeric Rating Scale Score (6.2 2.3), Health Assessment Questionnaire-Disability Index Score (1.3 0.6), and 36-Item Short Form Health Survey (SF-36) Physical Component Summary Score (34.0 9.0) compared to the normal group, with statistical significance (p ≤ 0.05). Similar numerical trends were observed for overweight group compared to normal group at BL, but without statistical significance (Table 1). SF-36 Mental Component Summary Scores were statistically significant for obesity (46.2 12.3) and overweight (47.0 11.8) groups compared to normal group. Current enthesitis diagnosis was higher in obesity (66.2%) and overweight (58.1%) groups compared to the normal group (54.4%).Patients with a higher BMI showed a greater prevalence of comorbidities at BL: cardiovascular disease (obesity 55.4%, overweight 36.0%, normal 18.1%), hypertension (obesity 51.9%, overweight 30.8%, normal 11.4%), hyperlipidaemia (obesity 5.5%, overweight 5.0%, normal 1.7%), diabetes (obesity 19.4%, overweight 12.8%, normal 3.4%), and metabolic dysfunction-associated liver disease (obesity 1.5%, overweight 0.7%, normal 0.7%). Conclusion Active PsA patients living with obesity/overweight experienced higher disease burden and BL cardiometabolic burdens like hypertension, hyperlipidaemia, diabetes, cardiovascular disease, and metabolic dysfunction-associated liver disease, underscoring unmet healthcare needs. Emerging therapeutic strategies offer rheumatologists opportunities to provide holistic care, shifting from disease management to health improvement addressing both active PsA and associated comorbidities. Disclosure P. Mease: Consultancies; AbbVie, Acelyrin, Amgen, Astra Zeneca, Bristol Myers Squibb, Century, Cullinan, Eli Lilly and Company, Inmagene, Johnson Employee and shareholder of Eli Lilly and Company. N. Bello: Corporate appointments; Employee and shareholder of Eli Lilly and Company. M. Ngantcha: Corporate appointments; Employee and shareholder of Eli Lilly and Company. L. Eder: Grants/research support; AbbVie, Eli Lilly and Company, UCB Pharma, Novo Nordisk, Fresenius Kabi, Pfizer, Johnson AbbVie, AMGEN, Astra Zeneca, AXIOM Health, Biogen, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Cellgen, Celltrion, Chugai Pharma Marketing Ltd., Deutscher Psoriasis-Bund, Fresenius Kabi, Gala. L. Coates: Grants/research support; Abbvie, Amgen, Janssen and UCB Pharma; worked as a paid consultant for AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly and Company, Enlivex, Janssen, Moonlake, Novartis, Pfizer, Takeda and UCB Pharma. J. Swift: Corporate appointments; Employee and shareholder of Eli Lilly and Company.