Sleeve gastrectomy is associated with a higher incidence of rheumatoid arthritis and spondyloarthritis compared to gastric bypass

Sleeve gastrectomy is associated with a higher incidence of rheumatoid arthritis and spondyloarthritis compared to gastric bypass. Download PDF Abstract To compare the incidence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) following three bariatric procedures—gastric bypass (GB), sleeve gastrectomy (SG), and adjustable gastric banding (AG)—using the French National Health Insurance Database. We conducted a nationwide retrospective cohort study of adults aged 18–65 years with morbid obesity (BMI ≥ 40 kg/m 2) who underwent primary bariatric surgery between 2012 and 2016.

Patients with prior immune-mediated inflammatory disorders, disease-modifying antirheumatic drug use, or previous rheumatology consultations were excluded. Incidence rates (IRs) of first RA and SpA diagnosis were calculated per 1,000 person-years (PY). Time-to-event analyses used Fine and Gray competing-risk models with time-dependent coefficients (< 6 years vs ≥ 6 years), adjusted for age, sex, obesity class, and Charlson Comorbidity Index.

Hazard ratios (HRs) and 95% confidence intervals (CIs) compared SG and AG with GB. Among 46,137 patients (SG, 28,431; GB, 13,438; AG, 4,268), 418,759 PY of follow-up were accrued and 244 incidents RA or SpA identified (0.58/1,000 PY). IRs were lowest after GB (0.43/1,000 PY), intermediate after AG (0.51/1,000 PY), and highest after SG (0.67/1,000 PY).

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