Impact of BMI on response to Janus kinase inhibitors in rheumatoid arthritis: an individual patient data meta-analysis of randomised controlled trials.
Lancet RheumatolAug 3, 2026 (epub)
Clinical ResearchRheumatology
Katie Bechman, Mark D Russell, Kathryn Biddle et al.
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In 30 seconds
This individual patient data meta-analysis evaluated the impact of BMI on the response to Janus kinase (JAK) inhibitors in 11,883 adults with rheumatoid arthritis. The study found that higher BMI was associated with reduced efficacy of JAK inhibitors, with adjusted relative risks for ACR20 response decreasing from 0.94 for overweight to 0.78 for class 3 obesity, indicating obesity as an effect modifier in treatment response.
Key findings
- Adjusted relative risk for ACR20 response was 0.94 for overweight and 0.78 for class 3 obesity.
- Adjusted mean differences for DAS28-CRP increased from 0.14 for overweight to 0.54 for class 3 obesity.
- 30.9% of participants had class 1-3 obesity, indicating a significant prevalence in this population.
- No BMI gradient was observed in the placebo group.
Why it matters
Understanding the relationship between BMI and treatment response to JAK inhibitors is crucial for optimizing management strategies in rheumatoid arthritis. This highlights the need for weight management as part of comprehensive care.