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Shedding Weight and Pain: The Promise of Anti-Obesity Medications in RA
With the advent of FDA-approved anti-obesity medications such as semaglutide and tirzepatide, a new avenue for managing this challenging patient population has emerged. But how might these drugs impact the trajectory of RA, and are we on the cusp of a paradigm shift?
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ACR 2024 - Day 1 Report
ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings. The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.
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Weight Loss from Anti-Obesity Medications Prevents Gout
A population based study looked at the effect of the weight loss drug, Orlistat, in obese individuals. Compared to those untreated, orlistat over 1 year was associated with significant weight loss and significantly lower risks of incident gout and recurrent gout flares among overweight or obese people.
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Potential Impact of Weight Loss Drugs in Rheumatic Diseases
Dr. Arthur Kavanaugh highlights a session regarding weight loss and improvement in disease outcomes, specific weight loss drugs (SGL-2 and GLP-1), along with downsides when patients stop these medications. Reporting… https://t.co/Ilu2FXK2xi https://t.co/7CKSnfuey4
Dr. John Cush RheumNow ( View Tweet)
Food for thought 🤔
Abstract 1900 found non-diet soda and certain supplements (folate, B-vitamins, fish oil) were higher among individuals with incident SpA compared to controls
@RheumNow #ACR24 https://t.co/qUXcxSfTxE
Akhil Sood MD AkhilSoodMD ( View Tweet)
2023 @ACRheum guidance recommends #MediterraneanDiet in RA
What are barriers/facilitators to following the diet?
Many pts are willing to try but don't follow it
Barriers➡️ food insecurity & aversions
Many are unaware
Do you talk to your pts about diet?
Ab1673 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Dietary changes are intermittent fasting are common in axial spondylarthritis (axSpA) patients, possibly reducing inflammation. A study found 55% currently on a diet and 31% fasting. Many believe these practices improve disease activity. Abstr#1459 #diet #axSpA @RheumNow #ACR24
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Medication-assisted weight loss has boomed in recent yrs. How does weight loss affect disease activity & PROs in RMDs?
≥5% weight loss, after taking a med, led to better disease activity & QoL
Data may inform RCTs to explore effect of these meds in RMDs
Ab0845 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Does alcohol consumption affect radiographic progression in axSpA?
Canadian cohort study over 6 years found greater radiographic progression among alcohol consumers.
Still a lot of confounding factors to fully establish an association.
Abst#0822 #ACR24
@RheumNow https://t.co/GG0rXq3kjC
Adela Castro AdelaCastro222 ( View Tweet)
A 6-year study of the link between alcohol consumption and spinal radiographic progression in axial spondyloarthritis (axSpA). Results indicate that alcohol may worsen spinal damage, particularly in males and those with radiographic axSpA. Future research should explore… https://t.co/IIvTyq7kBe
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
To GLP or not to GLP—is it still even a question in obesity management given pluripotent benefits 👇🏻
Dr. Louis Aronne recommends
➡️ Start low and titrate slow 💊
➡️ Provide pt education on GI side effects, ondansetron effective for nausea
#ACR24 @RheumNow https://t.co/SzVg2dopCo
Links:
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Planned to post so much more from #ACR24; my favorite slides from today will have to suffice.
From the #BCRC Dr Monica Guma’s - diet and microbiome.
Dr @NamrataRheum -a reminder that we are all aging.
Dr Connie Weyand’s -metabolic checkpoints in RA T cells and macrophage. https://t.co/MtsheVsUEQ
Links:
Kristen Young kristenyoung ( View Tweet)
Where do SGLT2i have proven benefits for CVD?
👉 Diabetes w/high CV risk
👉Heart failure (all EF)
👉CKD
Dr Weber @rheumnow #ACR24 https://t.co/vFYddrLP1Y
TheDaoIndex KDAO2011 ( View Tweet)
SELECT trial noted reduction in CV death, MI and stroke in obese pts without diabetes (other benefits: reduction in waist circumference, BP, lipids) @rheumnow # ACR24 https://t.co/GPK4Vg5bOt
Links:
TheDaoIndex KDAO2011 ( View Tweet)
#obesity causes a lot of diseases including #arthritis. How?
⬆️ IL-6
⬆️ leptin
⬆️ TNF-a
@RheumNow #ACR24
@rheumarhyme https://t.co/qeqTZUOEZy
sheila RHEUMarampa ( View Tweet)
The Plants for Joints RA continuation made it to #ACR24!
whole-food plant-based diet, exercise, sleep/stress Rx
(added on to usual RA care i.e. DMARDs)
Gains made during program were sustained,
can't undersell lifestyle as part of the overall picture!
#ACR24 ABST0530 @RheumNow https://t.co/XSLIwYitpH https://t.co/RfiTX8Z6ff
Links:
David Liew drdavidliew ( View Tweet)
Year in review:
Semaglutide reduced knee pain over 68 weeks in patients with high BMI and moderate knee #osteoarthritis pain
But mechanism of knee pain improvement not yet known if due to wgt loss or other mechanisms.
@Rheumnow #ACR24 @rheumarhyme @theactiverheum https://t.co/PkrcIMbgPl
sheila RHEUMarampa ( View Tweet)
Weight Loss from Anti-Obesity Medications Prevents Gout
A population based study looked at the effect of the weight loss drug, Orlistat, in obese individuals. Compared to those untreated, orlistat over 1 year was associated with significant weight loss and significantly lower… https://t.co/P1iRjtHgHV https://t.co/MoohUKGvUn
Dr. John Cush RheumNow ( View Tweet)
NHANES study of 11264 adolescents (12–17 yrs) found Hyperuricemia (≥ 5.5 mg/dL) in 33%, (51% males, 13% females) and was more prevalent with obesity and in non-Hispanic Asians https://t.co/rwUt1Cgg9b https://t.co/dFr1LeX0nC
Dr. John Cush RheumNow ( View Tweet)
EULAR Review of Lifestyle Improvements for Rheumatic Patients
A EULAR taskforce evaluated lifestyle behaviors' effects on rheumatic and musculoskeletal diseases (RMDs), finding moderate evidence for minor benefits from certain dietary components. However, high-level evidence on… https://t.co/maaz8W5IUT https://t.co/QiE6Oo1MzX
Dr. John Cush RheumNow ( View Tweet)
