E141 Obesity is associated with higher disease activity and lower health-related quality of life in psoriatic arthritis treatment responders

Abstract Background/Aims Approximately 27-40% of patients with psoriatic arthritis (PsA) have obesity, which is associated with poorer clinical outcomes and reduced treatment response. Among responders to PsA treatment, the impact of body mass index (BMI) on outcomes has not been assessed. This analysis investigated the effects of obesity on health-related quality of life (HR-QoL) and disease activity in ACR50 or DAPSA LDA responders. Methods This post-hoc, unadjusted, treatment-agnostic analysis included patients with PsA from the SPIRIT-P1, -P2, and -H2H studies, receiving ixekizumab or adalimumab. Patients achieving ACR50 or DAPSA LDA at week 24 (W24) were categorised based on BMI: 25 kg/m2 (Normal), 25-30 kg/m2 (Overweight), and ≥30 kg/m2 (Obesity) at baseline. HR-QoL outcomes included Health Assessment Questionnaire-Disability Index (HAQ-DI) and fatigue severity numeric rating scale (NRS). Disease activity was evaluated using pain visual analogue scale (VAS), swollen joint count (SJC), tender joint count (TJC), Patient Global Assessment of Disease Activity (PatGA), Physician Global Assessment of Disease Activity (PGA), and C-reactive protein (CRP). Observed data were presented. Non-parametric (Mann-Whitney U) test was used to account for non-normal distribution of some parameters; overweight or obesity subgroups were compared to the normal BMI subgroup; p 0.05 denoted statistical significance. Results Among patients achieving ACR50 by W24, statistically significant differences were observed between obesity and normal BMI subgroups for HAQ-DI, fatigue severity NRS, pain VAS, PatGA, and CRP, and between overweight and normal BMI subgroups for CRP. Among patients achieving DAPSA LDA by W24, statistically significant differences were observed between obesity and normal BMI subgroups for fatigue NRS, PatGA, and CRP, and between overweight and normal BMI subgroups for pain VAS, PatGA, and CRP. Differences between PGA, SJC, and TJC were not statistically significant across BMI subgroups for patients achieving ACR50 or DAPSA LDA at W24 (Table 1). Conclusion In patients with PsA achieving stringent treatment targets, obesity is associated with some indicators of negative impact on PsA disease activity and HR-QoL. While with current advanced therapies patients with PsA and obesity can achieve effective improvement, patients’ functional ability, HR-QoL, and other health outcomes may further be improved by also treating their comorbid obesity. Disclosure J.F. Merola: Consultancies; AbbVie, Amgen, Biogen, Bristol Myers Squibb, Dermavant, Eli Lilly and Company, Janssen, LEO Pharma, Novartis, Pfizer, Regeneron, Sanofi, Sun Pharma, and UCB Pharma. W. Tillett: Honoraria; AbbVie, Amgen, Celgene, Eli Lilly and Company, Janssen, Merck Sharp AbbVie, Amgen, BIOCAD, Biogen, Chugai Pharmaceutical, Eli Lilly and Company, Grünenthal, Janssen, Merck Sharp AbbVie, Bristol Myers Squibb, Celgene, Eli Lilly and Company, GlaxoSmithKline, Janssen, Novartis, Pfizer, and UCB Pharma. E.L. Perkins: Consultancies; AbbVie, Bristol Myers Squibb, Eli Lilly and Company, Johnson Employee and shareholder of Eli Lilly and Company. M. Ngantcha: Corporate appointments; Employee and shareholder of Eli Lilly and Company. B. Ibe: Corporate appointments; Employee and shareholder of Eli Lilly and Company. R. Burge: Corporate appointments; Employee and shareholder of Eli Lilly and Company. A. Kronbergs: Corporate appointments; Employee and shareholder of Eli Lilly and Company. N. Madsen: Consultancies; Eli Lilly and Company. Grants/research support; Bristol Myers Squibb, Eli Lilly and Company, Johnson Employee and shareholder of Eli Lilly and Company.