Weight loss, disease activity, and patient reported outcomes in patients with musculoskeletal and autoimmune diseases taking weight loss medications: a retrospective cohort study

Abstract

Introduction

Given potential impacts of adiposity on pain and inflammation, we evaluated if weight loss was associated with improvements in disease activity and patient reported outcomes (PROs) in people with rheumatic and musculoskeletal disease (RMD) using weight loss therapies.

Methods

Participants with RMDs enrolled in the FORWARD Databank and reporting weight loss medication use were included in this retrospective cohort study. Linear models using generalized estimating equations assessed the association with ≥5 % weight loss and changes in PROs and disease activity over a 6-month period, clustering by participant and adjusting for the prior 6-month PRO, BMI, diabetes status, age, and sex. Testing for effect modification was performed to assess whether the effect of weight loss varied across BMI categories and across condition.

Results

We identified 3868 users of weight loss medications with 24,484 discrete observations. Weight loss ≥5 % was reported in 10.5 % (2603) of observations and was associated with improvements in patient activity scale II (PAS-II), patient global assessment, pain, fatigue, polysymptomatic distress, and SF-36 physical component score (PAS-II adjusted: B -0.12, 95 % CI -0.17, -0.067, p < 0.001). Those who lost ≥5 % of weight were more likely to have improvements in PAS-II and PROs if they were obese, independent of diagnosis.

Conclusion

Among participants with RMDs that reported weight loss medication use, ≥5 % weight loss was associated with statistically significant improvements in patient-reported disease activity and quality of life PROs. The use of weight loss medications could be considered in trials aimed at improving symptoms of RMDs.