Cachexia in rheumatoid arthritis

Walsmith, Joseph; Roubenoff, Ronenn

doi:10.1016/s0167-5273(02)00237-1

Cited by 239 publications

(216 citation statements)

References 39 publications

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“…observed rates of sarcopaenia similar to ours (21.4% in women with RA and 33.3% in men with RA) by using alternative SMI cut points for sarcopaenia without muscle function assessment 28. The mechanisms responsible for muscle loss have yet to be elucidated but could involve disease activity, the reduced mobility, and corticosteroid treatment 6, 30, 31. In turn, altered body composition is likely to impact health and causes a cascade of cardiometabolic abnormalities 32, 33…”

Section: Discussionmentioning

confidence: 99%

Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis

Tournadre

Pereira

Dutheil

et al. 2017

J cachexia sarcopenia muscle

145

132

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BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by increased mortality associated with cardiometabolic disorders including dyslipidaemia, insulin resistance, and cachectic obesity. Tumour necrosis factor inhibitors and interleukin 6 receptor blocker licensed for the treatment of RA decrease inflammation and could thus improve cardiovascular risk, but their effects on body composition and metabolic profile need to be clarified. We investigated the effects of tocilizumab (TCZ), a humanized anti‐interleukin 6 receptor antibody, on body composition and metabolic profile in patients treated for RA.MethodsTwenty‐one active RA patients treated with TCZ were included in a 1 year open follow‐up study. Waist circumference, body mass index, blood pressure, lipid profile, fasting glucose, insulin, serum levels of adipokines and pancreatic/gastrointestinal hormones, and body composition (dual‐energy X‐ray absorptiometry) were measured at baseline and 6 and 12 months of treatment. At baseline, RA patients were compared with 21 non‐RA controls matched for age, sex, body mass index, and metabolic syndrome.ResultsCompared with controls, body composition was altered in RA with a decrease in total and appendicular lean mass, whereas fat composition was not modified. Among RA patients, 28.6% had a skeletal muscle mass index below the cut‐off point for sarcopaenia (4.8% of controls). After 1 year of treatment with TCZ, there was a significant weight gain without changes for fat mass. In contrast, an increase in lean mass was observed with a significant gain in appendicular lean mass and skeletal muscle mass index between 6 and 12 months. Distribution of the fat was modified with a decrease in trunk/peripheral fat ratio and an increase in subcutaneous adipose tissue. No changes for waist circumference, blood pressure, fasting glucose, and atherogenic index were observed.ConclusionsDespite weight gain during treatment with TCZ, no increase in fat but a modification in fat distribution was observed. In contrast, muscle gain suggests that blocking IL‐6 might be efficient in treating sarcopaenia associated with RA.

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Section: Discussionmentioning

confidence: 99%

Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis

Tournadre

Pereira

Dutheil

et al. 2017

J cachexia sarcopenia muscle

145

132

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“…This might be explained, at least in part, by the relationship between disease phase and subcutaneous adiposity (r ϭ 0.49, P ϭ 0.03), illustrating the effects of corticosteroid therapy on subcutaneous adiposity. Moreover, myopathic obesity, similar to rheumatic obesity (24), might also account for the increased body fat levels and the reduced exercise capacity. In several diseases, a significant relationship has been found between plasma levels of inflammatory parameters (in particular tumor necrosis factor ␣) and protein breakdown (25).…”

Section: Discussionmentioning

confidence: 99%

“…In several diseases, a significant relationship has been found between plasma levels of inflammatory parameters (in particular tumor necrosis factor ␣) and protein breakdown (25). In addition, during the restoration phase, the damaged muscle tissue might be in part replaced by adipose tissue, altering the body composition of these patients (24,26).…”

Section: Discussionmentioning

confidence: 99%

Anaerobic exercise capacity in patients with juvenile‐onset idiopathic inflammatory myopathies

Takken¹,

Net²,

Helders³

2005

Arthritis & Rheumatism

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Objective. To 1) report the feasibility of an "all-out" 30-second cycling exercise test (Wingate Anaerobic Exercise Test [WAnT]) in juvenile-onset idiopathic inflammatory myopathy (JIIM) patients, 2) describe the anaerobic exercise capacity in juvenile dermatomyositis patients, and 3) determine if the anaerobic exercise capacity could be related to disease duration or disease phase. Methods. Twenty patients (age 14.13 ؎ 5.4 years) with JIIM participated in this study. All patients were able to perform the WAnT without adverse events. Results. Comparison with healthy controls revealed a -29.3 ؎ 26.58% (P ‫؍‬ 0.001) and -27.6 ؎ 25.7% (P ‫؍‬ 0.002) impairment in mean power and peak power on the WAnT, respectively. The WAnT correlated with disease phase and with knee extensor muscle strength. Conclusion. The WAnT might be a valuable adjunct next to other assessment tools in the followup of JIIM patients.

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“…Due to intense immune cellular activity, increased metabolic demand, and energy expenditure, the glycolytic pathways are intensely activated. K is required for several enzymes (glucose phosphate isomerase, enolase, and aldolase) which participate in the glycolytic pathway [68][69][70]. It is probable that these hyperactive states require excess K, and thus, there is an overutilization of K. In RA patients, there may be a relative (intracellular due to electrolyte shifts) or absolute deficiency of body K. It is prudent to add that there is an important 7 relationship between K and cortisol status [61,71].…”

Section: Potassium (K)mentioning

confidence: 99%

A therapeutic role for potassium (K) to reduce pain and complications related to the cardiovascular system and bone in rheumatoid arthritis (RA): A clinical research perspective

Kianifard¹,

Chopra²

2018

Rheum Res

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Cachexia in rheumatoid arthritis

Cited by 239 publications

References 39 publications

Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis

Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis

Anaerobic exercise capacity in patients with juvenile‐onset idiopathic inflammatory myopathies

A therapeutic role for potassium (K) to reduce pain and complications related to the cardiovascular system and bone in rheumatoid arthritis (RA): A clinical research perspective

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