Summary of rheumatic disease outcomes following bariatric surgery in selected studies.
| Disease | Study | Subjects/Surgery | Outcomes |
|---|---|---|---|
| OA | Hacken, et al19 | 24 pts with knee OA (19 RYGB, 4 GB, 1 with SG) | ↓ all variables KOOS and WOMAC at 6, 12, and 24 mos |
| Richette, et al20 | 44 pts with knee OA (38 RYGB, 6 GB) | ↓ all variables WOMAC and ↓ pain score from 50 to 25 (VAS) | |
| Abu-Abeid, et al21 | 64 pts with knee pain and early radiographic OA | ↑ 0.655-mm joint space at 3 mos | |
| Function score ↑ from 78.5 to 90.69 (out of 100) | |||
| Gout | Romero-Talamás, et al26 | 99 pts with gout (69 RYGB, 22 SG, 8 GB) compared with 56 pts with gout undergoing nonbariatric abdominal surgery | ↑ “early” gout attacks (18% in bariatric surgery group compared with 2% in abdominal surgery group) |
| % of pts with at least 1 gout attack ↓ from 24 prior to surgery to 8 during postop mos 1–13 | |||
| RA | Sparks, et al30 | 53 pts with RA (43 RYGB, 7 GB, 3 SG) | ↓ in no. pts with moderate/high disease activity from 57% to 6% |
| No. pts in remission ↑ from 26% to 74% at 5.8 yrs | |||
| Fewer RA medications, lower ESR and CRP | |||
| Psoriasis and PsA | Sethi, et al31 | 86 pts with psoriasis | Disease severity score ↓ from 5.6 to 4.4 (0–10 scale) |
| 21 also with PsA | ↓ score 6.6 to 4.5 | ||
| SLE | Corcelles, et al32 | 31 pts with SLE (23 RYGB, 3 SG, 5 other) | 42% pts ↓ IS medication 3 yrs postsurgery |
| 19% not receiving steroids | |||
| 13% major postop complication | |||
| OP | Lalmohamed, et al46 | 2079 pts (1249 GB, 613 RYBG, 217 other), 10,442 controls | No increase in OP fracture rate at 2.2 yrs |
| Trend to ↑ fracture risk 3–5 yrs postsurgery in those with most EWL | |||
| Nakamura, et al47 | 258 pts (243 RYGB, 15 other) | 79 pts with 132 fractures | |
| 2-fold ↑ risk of fracture |
OA: osteoarthritis; pts: patients; RYGB: Roux-en-Y gastric bypass; GB: gastric band; SG: sleeve gastrectomy; KOOS: Knee OA Outcome Score; WOMAC: Western Ontario and McMaster Universities OA Index; VAS: visual analog scale; postop: postoperative; RA: rheumatoid arthritis; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; PsA: psoriatic arthritis; IS: immunosuppressive; SLE: systemic lupus erythematosus; OP: osteoporosis; EWL: excess weight loss.