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Obesity has been shown to be a risk factor for the onset of rheumatoid arthritis (RA) and also shown to affect outcomes by impairing responses to many DMARD therapies. A Swiss study of RA patients undergoing bariatric surgery failed to show that bariatric surgery and weight loss had any effect on the incidence of RA.
The study examined patients in the Swedish Obese Subjects (SOS) study, which included 2002 obese patients who underwent bariatric surgery and 2034 matched controls. While none had RA at baseline, there were 92 incident cases of RA.
Bariatric surgery did not alter the cohort risk of incident RA by 2 different analyses (Intent to treat: HR 0.92; 95% CI 0.59, 1.46, P = 0.74; per-protocol HR 0.86; 95% CI 0.54, 1.38, P = 0.53). The bariatric surgery group lost considerable weight that was sustained (−17% BMI at 10 years) compared to +1.7% BMI for controls.
Similarly weight changes at the 2 year follow-up failed to predict the development of RA.
Risk factors for future RA included higher CRP levels and smoking.