TNF and obesity due to melanocortin 4 receptor deficiency: PsA patients who were obese had higher disease burden measured by PsAID and Routine Assessment of Patient Index Data (RAPID3).31 In a longitudinal cohort, PsA patients with obesity had a lower probability of achieving sustained MDA.16 Among patients initiating TNF inhibitor treatment, obesity was a strong predictor of not achieving Clinical Disease Activity Index remission,17 while weight loss was associated with a higher rate of achieving MDA.32 Our study findings generally expand those reported in the literature.