AUTHOR=Borg Alexander , Lindblom Julius , Gomez Alvaro , Soltani Ameneh , Enman Yvonne , Heintz Emelie , Regardt Malin , Grannas David , Emamikia Sharzad , Parodis Ioannis 

TITLE=Obesity is associated with pain and impaired mobility despite therapy in systemic lupus erythematosus

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1247354

DOI=10.3389/fmed.2023.1247354

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Objective</title><p>To investigate whether abnormal BMI is associated with health-related quality of life (HRQoL) impairments, defined as patient-reported problems within the different dimensions of the three-level EQ-5D (EQ-5D-3L), before and after treatment for active systemic lupus erythematosus (SLE).</p></sec><sec id="sec2"><title>Patients and methods</title><p>We conducted a post-hoc analysis of data from two phase III clinical trials of belimumab in SLE, i.e., BLISS-52 (<italic>n</italic> = 865) and BLISS-76 (<italic>n</italic> = 819). Underweight was defined as BMI &lt;18.5 kg/m<sup>2</sup>, normal weight as BMI ≥18.5 but &lt;25 kg/m<sup>2</sup>, pre-obesity as BMI ≥25 but &lt;30 kg/m<sup>2</sup>, and obesity as BMI ≥30 kg/m<sup>2</sup>. We investigated associations between BMI groups and problems (level 2 or 3) within each one of the five EQ-5D dimensions before treatment initiation and at week 52, using logistic regression analysis adjusting for age, ethnicity, disease activity, and glucocorticoid dose, and for the post-treatment analysis also for belimumab treatment and baseline EQ-5D-3L responses.</p></sec><sec id="sec3"><title>Results</title><p>Of 1,684 patients included, 73 (4%) were classified as underweight, 850 (50%) as normal weight, 438 (26%) as pre-obese, and 323 (19%) as obese. At baseline, obesity was associated with mild to severe problems in all EQ-5D dimensions (<italic>p</italic> &lt; 0.05 for all), yielding the strongest association with problems in mobility (adjusted odds ratio, aOR: 2.1; 95% confidence interval, CI: 1.6–2.8; <italic>p</italic> &lt; 0.001). Pre-obesity was also associated with problems in mobility (aOR: 1.4; 95% CI: 1.1–1.8; <italic>p</italic> = 0.005). Post-intervention, obesity was associated with problems in mobility and pain/discomfort, and pre-obesity with problems in mobility and self-care (<italic>p</italic> &lt; 0.05 for all).</p></sec><sec id="sec4"><title>Conclusion</title><p>Our study adds to the evidence that high BMI negatively affects SLE patients’ HRQoL, with obesity being associated with pain and impaired mobility despite therapy.</p></sec>