A late breaking abstract presented at ACR 2014 aimed to evaluate the effect of substantial weight loss after bariatric surgery on RA disease activity, inflammatory markers, and RA-related medication usage.
This was a retrospective review of 53 RA patients who underwent bariatric surgery from 2000 to 2012. The majority (94%) were female with a mean age of 47.9 years, a mean weight of 128.2 kg, and the mean duration of RA was 8.6 years. Only 51% were seropositive for either RF or CCP. For most patients, a Roux-en-Y bypass was performed.
At 12 months, the average weight loss was 41 kg. RA-related disease activity improved and so did the use of RA-related medication. At 1 year, 68% were in remission and 23% were taking no RA-related medications.
The CRP and ESR fell significantly. The starting mean CRP was 26.1 mg/L and at 12 months it was 5.9 mg/L. The ESR fell similarly from 45.7 to 18 mm/hr.
This study begs the question, was the improvement in RA outcomes in this population entirely due to weight loss or could it be due to the surgical procedure (Roux-en-Y) utilized to impart the weight loss? Was the “microbiome” altered?