{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:53:39Z","timestamp":1790776419753,"version":"4.1.0"},"reference-count":57,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,5,9]],"date-time":"2020-05-09T00:00:00Z","timestamp":1588982400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2020,5,3]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In axial spondyloarthritis (axSpA), higher body mass index (BMI) is associated with worse outcomes including response to biologics. Further clarity is needed on whether BMI is associated with disease activity overall, independent of treatment response. We performed a systematic review and meta-analysis to assess the association between BMI and disease activity as reported by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) or Ankylosing Spondylitis Disease Activity Score (ASDAS) in axSpA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We systematically searched for studies evaluating BMI and disease activity as the exposure and outcome of interest, respectively, in axSpA. Using random effects models, we estimated summary standardised mean differences (SMDs) and 95% CIs of BASDAI or ASDAS, comparing obese (BMI&gt;30 kg\/m<jats:sup>2<\/jats:sup>) or overweight\/obese (BMI&gt;25 kg\/m<jats:sup>2<\/jats:sup>) individuals to those with normal BMI (18.5\u201324.9 kg\/m<jats:sup>2<\/jats:sup>).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s3\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twelve studies were included in the meta-analysis. Among all studies reporting the BASDAI at baseline, the pooled SMD of the BASDAI for those with an obese or overweight\/obese BMI compared to a normal BMI was 0.38 (95% CI 0.21 to 0.55, I<jats:sup>2<\/jats:sup> =75.2%), indicating a significant association of higher BMI with higher BASDAI score. The pooled SMD of the ASDAS for those with an obese or overweight\/obese BMI compared to a normal BMI was 0.40 (95% CI 0.27 to 0.54, I<jats:sup>2<\/jats:sup>=0%). Findings were robust across subgroup analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s4\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These results demonstrate an association between an overweight\/obese BMI and higher disease activity in studies of axSpA. Future longitudinal studies of BMI and disease activity should assess how this association changes over time.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001225","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T20:55:23Z","timestamp":1590008123000},"page":"e001225","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Association of body mass index on disease activity in axial spondyloarthritis: systematic review and meta-analysis"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8104-2450","authenticated-orcid":false,"given":"Jean W","family":"Liew","sequence":"first","affiliation":[{"name":"Medicine, Division of Rheumatology, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irvin J","family":"Huang","sequence":"additional","affiliation":[{"name":"Medicine, Division of Rheumatology, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana N","family":"Louden","sequence":"additional","affiliation":[{"name":"University Libraries, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namrata","family":"Singh","sequence":"additional","affiliation":[{"name":"Medicine, Division of Rheumatology, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianne S","family":"Gensler","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,5,20]]},"reference":[{"key":"2025090312294414000_6.1.e001225.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.151191"},{"key":"2025090312294414000_6.1.e001225.2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20408"},{"key":"2025090312294414000_6.1.e001225.3","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2470"},{"key":"2025090312294414000_6.1.e001225.4","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s13075-017-1315-z","article-title":"Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events? 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