{"doi":"10.1002/acr2.11639","title":"Effect of Remotely Supervised Weight Loss and Exercise Training Versus Lifestyle Counseling on Cardiovascular Risk and Clinical Outcomes in Older Adults With Rheumatoid Arthritis: A Randomized Controlled Trial","abstract":"OBJECTIVE: To compare a remotely supervised weight loss and exercise intervention to lifestyle counseling for effects on cardiovascular disease risk, disease activity, and patient-reported outcomes in older patients with rheumatoid arthritis (RA) and overweight/obesity. METHODS: Twenty older (60-80 years), previously sedentary participants with seropositive RA and overweight/obesity were randomized to 16 weeks of either Supervised Weight loss and Exercise Training (SWET) or Counseling Health As Treatment (CHAT). The SWET group completed aerobic training (150 minutes/week moderate-to-vigorous intensity), resistance training (two days/week), and a hypocaloric diet (7% weight loss goal). The CHAT control group completed two lifestyle counseling sessions followed by monthly check-ins. The primary outcome was a composite metabolic syndrome z-score (MSSc) derived from fasting glucose, triglycerides, high density lipoprotein-cholesterol, minimal waist circumference, and mean arterial pressure. Secondary outcomes included RA disease activity and patient-reported outcomes. RESULTS: Both groups improved MSSc (absolute change -1.67 ± 0.64 in SWET; -1.34 ± 1.30 in CHAT; P < 0.01 for both groups) with no between-group difference. Compared with CHAT, SWET significantly improved body weight, fat mass, Disease Activity Score-28 C-reactive protein, and patient-reported physical health, physical function, mental health, and fatigue (P < 0.04 for all between-group comparisons). Based on canonical correlations for fat mass, cardiorespiratory fitness, and leg strength, component-specific effects were strongest for (1) weight loss improving MSSc, physical health, and mental health; (2) aerobic training improving physical function and fatigue; and (3) resistance training improving Disease Activity Score-28 C-reactive protein. CONCLUSION: In older patients with RA and overweight/obesity, 16 weeks of remotely supervised weight loss, aerobic training, and resistance training improve cardiometabolic health, patient-reported outcomes, and disease activity. Less intensive lifestyle counseling similarly improves cardiovascular disease risk profiles, suggesting an important role for integrative interventions in the routine clinical care of this at-risk RA population.","journal":"ACR Open Rheumatology","year":2023,"id":330170,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8551,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":529954,"name":"Leanna M. Ross","orcid":"0000-0002-1407-1622","position":1,"is_corresponding":false},{"id":1054441,"name":"Alyssa M Sudnick","orcid":null,"position":2,"is_corresponding":false},{"id":235343,"name":"Johanna L. Johnson","orcid":"0000-0001-9766-1814","position":3,"is_corresponding":false},{"id":282555,"name":"Carl F. Pieper","orcid":"0000-0003-4809-1725","position":4,"is_corresponding":false},{"id":1054442,"name":"Kelsey B. Belski","orcid":null,"position":5,"is_corresponding":false},{"id":821296,"name":"Julie Counts","orcid":"0000-0002-0872-5810","position":6,"is_corresponding":false},{"id":1054443,"name":"Alyssa King","orcid":null,"position":7,"is_corresponding":false},{"id":1054444,"name":"Jessica Wallis","orcid":null,"position":8,"is_corresponding":false},{"id":609045,"name":"William Bennett","orcid":"0000-0002-5776-3178","position":9,"is_corresponding":false},{"id":1054445,"name":"Jillian C. Gillespie","orcid":null,"position":10,"is_corresponding":false},{"id":1054446,"name":"Kaileigh M. Moertl","orcid":null,"position":11,"is_corresponding":false},{"id":1054447,"name":"Dylan Richard","orcid":null,"position":12,"is_corresponding":false},{"id":383772,"name":"Janet L. Huebner","orcid":"0000-0003-1431-1638","position":13,"is_corresponding":false},{"id":293941,"name":"Margery A. Connelly","orcid":"0000-0002-3917-592X","position":14,"is_corresponding":false},{"id":530897,"name":"Ilene C. Siegler","orcid":null,"position":15,"is_corresponding":false},{"id":231464,"name":"William E. Kraus","orcid":"0000-0003-1930-9684","position":16,"is_corresponding":false},{"id":596742,"name":"Connie W. Bales","orcid":null,"position":17,"is_corresponding":false},{"id":719449,"name":"Kathryn N. Porter Starr","orcid":"0000-0002-0229-9742","position":18,"is_corresponding":false},{"id":235342,"name":"Kim M. Huffman","orcid":"0000-0003-4708-4734","position":19,"is_corresponding":false},{"id":684968,"name":"Brian J. Andonian","orcid":"0000-0003-1847-0660","position":0,"is_corresponding":true}],"reference_count":57,"raw_metadata":null,"created_at":"2026-07-19T01:09:10.120703Z","pmid":"38126260","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}