Weight-Loss Treatment Effective for Patients With PsA

A structured weight-loss treatment for patients with psoriatic arthritis and obesity saw improvements in body weight and total body fat with no negative effects on muscle strength.

A total of 98 patients—46 in the PsA group (both PsA and obesity) and 52 in the control group (obesity, no rheumatic disease or psoriasis)—were included in the 12-month study. The program included a very low energy diet, followed by structured reintroduction of an energy-restricted diet and brief support for physical activity. The primary outcome was muscle strength as defined by hand-grip strength (Grippit) and leg muscle strength (timed stand test). Secondary outcomes included cardiorespiratory fitness, body composition, and physical functioning. Assessments were completed at baseline, 6 months, and 12 months.

For PsA group, the median weight reduction at month 6 was 18.9 kg compared to 23.0 kg for the control group. At month 12, median weight reduction from baseline for patients was 16.1 kg, which corresponded with significant loss of total fat mass and lean mass. In both patients and control, leg muscle strength and physical functioning improved at month 6 and remained improved at month 12. Hand-grip strength was unchanged across both groups. Cardiorespiratory fitness increased in controls at months 6 and 12, but not in the patient group.

While there was benefit from weight loss treatment without the risk of muscle deterioration, the study authors wrote that since muscle strength and cardiorespiratory fitness were below the recommended values for the majority of patients, “more structured exercise strategies may be warranted to counteract physical fitness deficiencies in patients with PsA undergoing weight loss treatment.”

—Allison Casey

Billberg A, Larsson I, Björkman S, Eliasson B, Klingberg E. The impact of a structured weight-loss treatment on physical fitness in patients with psoriatic arthritis and obesity compared to matched controls: A prospective interventional study. Clin Rheumatol. Published online: June 1, 2022. DOI: 10.1007/s10067-022-06164-5