Impact of bariatric surgery on disease activity in patients with spondyloarthritis

Abstract

Objective: To evaluate whether undergoing bariatric surgery—compared to not undergoing the procedure—influences disease activity in individuals at risk for or diagnosed with spondyloarthritis, thereby preventing or worsening its clinical course. Methods: Exploratory and descriptive systematic review, following a pre-defined protocol. Evaluation via the Joanna Briggs Institute (JBI) checklist, analyzing clear objectives, sample adequacy, instrument validity, and statistical robustness. Results: Included 12 studies (2 clinical trials, 6 observational studies, and 4 cross-sectional studies), evaluated with RoB 2 and JBI. Significant clinical improvement was observed post-surgery: reduction in low back pain, increased mobility, a decrease of up to 60% in BASDAI/BASFI scores, reduction in inflammatory protectors (CRP, TNF-α), as well as improvements in physical function and quality of life. There was no worsening of the disease, but nutritional deficiencies were associated, emphasizing the need for prolonged monitoring. Thus, surgery demonstrates clinical and inflammatory benefits, without worsening of spondyloarthritis activity. Final considerations: Despite the limitations, the results indicate a predominantly beneficial effect of bariatric surgery on systemic infection and clinical stages of obese patients with spondyloarthritis.