Obesity is a comorbidity that plays a role in the development and severity of inflammatory joint diseases, including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. The relationships between obesity and adipose tissue and the treatments given for inflammatory joint diseases are bidirectional. In fact, biological agents (bDMARDs) and targeted synthetic agents (tsDMARDs) may influence body weight and body composition of treated patients, while obesity in turn may influence clinical response to these agents. Obesity is a prevalent comorbidity mainly affecting patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) with specific phenotypes. Tumour necrosis factor alpha (TNFα) inhibitors have been associated with changes in body composition by improving lean mass, but also by significantly increasing fat mass, which localized toward the abdominal/visceral region. The IL-6 inhibitor tocilizumab is associated with an increase in lean mass without change in fat mass. The clinical response to TNFα inhibitors is attenuated by obesity, an effect that is less pronounced with IL-6 inhibitors and the B-cell depletion agent rituximab. Conversely, body weight has no influence on the response to the costimulation inhibitor abatacept. These effects may be of help to the physician in personalized medicine, and may guide the therapeutic choice in obese/overweight patients.

中文翻译：

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炎症性关节疾病中使用的生物合成药物和目标合成药物与肥胖或身体组成之间的相互关系。

肥胖症是一种合并症，在包括风湿性关节炎，银屑病关节炎和轴突性脊柱关节炎在内的炎性关节疾病的发展和严重程度中起作用。肥胖与脂肪组织之间的关系以及炎症性关节疾病的治疗是双向的。实际上，生物制剂（bDMARDs）和靶向合成制剂（tsDMARDs）可能会影响所治疗患者的体重和身体成分，而肥胖又可能影响对这些药物的临床反应。肥胖是一种普遍的合并症，主要影响具有特定表型的类风湿性关节炎（RA）和银屑病关节炎（PsA）的患者。肿瘤坏死因子α（TNFα）抑制剂通过改善瘦肉质量，但也通过显着增加脂肪质量，与身体成分发生变化，定位于腹部/内脏区域。IL-6抑制剂tocilizumab与无脂肪量增加而不增加脂肪量有关。肥胖减轻了对TNFα抑制剂的临床反应，这种作用在IL-6抑制剂和B细胞耗竭剂利妥昔单抗中并不明显。相反，体重对共刺激抑制剂阿巴西普的反应没有影响。这些效果可能对个性化医学的医生有所帮助，并可能指导肥胖/超重患者的治疗选择。IL-6抑制剂和B细胞耗竭剂利妥昔单抗的作用较不明显。相反，体重对共刺激抑制剂阿巴西普的反应没有影响。这些效果可能对个性化医学的医生有所帮助，并可能指导肥胖/超重患者的治疗选择。IL-6抑制剂和B细胞耗竭剂利妥昔单抗的作用较不明显。相反，体重对共刺激抑制剂阿巴西普的反应没有影响。这些效果可能对个性化医学的医生有所帮助，并可能指导肥胖/超重患者的治疗选择。