Fluctuations in weight have been linked to cardiovascular (CV) outcomes in the general population. Whether weight fluctuation was independently predictive of CV events in patients with rheumatoid arthritis (RA) was evaluated. Weight change was categorized as a loss of ≥10%, loss of 5‐10%, stable, gain of 5‐10%, and  ≥10%. Cox proportional hazard models explored independent associations between time‐varying weight change and weight variability and risk of CV events before and after adjusting for CV risk factors, RA disease features, and disability.

Among 31,381 participants, those that lost or gained 10% of their weight had greater disease activity, worse physical function, and were more likely to smoke, have diabetes, use corticosteroids, and be disabled. In adjusted models, a greater risk of CV events was observed in those that experienced 10% weight loss or weight gain. The association between weight change and CV events was stronger among participants with BMI <25 kg/m2 for 10% weight loss and 10% weight gain. Patients with greater variability in weight had a higher risk of CV events.

In conclusion, recent changes and high variability in weight predict CV events in RA, particularly among thin patients. Further study is necessary to determine if weight fluctuation has adverse cardiometabolic consequences independent of other risk factors.

Ref: https://onlinelibrary.wiley.com/doi/10.1002/acr.24469