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Title: Blockade of tumour necrosis factor-{alpha} in rheumatoid arthritis: effects on components of rheumatoid cachexia
Authors: Metsios, Giorgos S.
Stavropoulos-Kalinoglou, Antonios
Douglas, Karen M. J.
Koutedakis, Yiannis
Nevill, Alan M.
Panoulas, Vasileios F.
Kita, Marina D.
Kitas, George D.
Citation: Rheumatology, 46(12): 1824-1827
Publisher: Oxford University Press (Oxford Journals)
Journal: Rheumatology
Issue Date: 2007
DOI: 10.1093/rheumatology/kem291
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Abstract: Objectives. Rheumatoid arthritis (RA) is accompanied by increased resting energy expenditure (REE) and decreased fat-free mass (FFM). This is referred to as rheumatoid cachexia and is attributed to high levels of tumour necrosis factor-{alpha} (TNF-{alpha}). This study aimed to investigate the effects of anti-TNF-{alpha} therapy on REE, body composition, physical activity and protein intake in RA patients. Methods. Twenty RA patients [50% female; age: (mean ± S.D.) 61.1 ± 6.8 yrs; body mass index (BMI): 28.3 ± 3.7 kg/m2] and 12 age–sex–BMI-matched healthy controls were assessed. REE (indirect calorimetry), body composition (bioelectrical impedance), the International Physical Activity Questionnaire (IPAQ), diet, Health Assessment Questionnaire (HAQ), disease activity [disease activity score 28 (DAS28), erythrocyte sedimentation rate (ESR), C-reactive protein] and serum TNF-{alpha} were measured before (Baseline) as well as 2 weeks (Time-1) and 12 weeks (Time-2) after initiation of anti-TNF-{alpha} treatment. Controls were only assessed at Baseline. Results. RA patients had significantly higher REE than controls at Baseline (1799.4 ± 292.0 vs 1502.9 ± 114.5 kcal/day, P = 0.002). Within the RA group, REE increased significantly between Time-1 and Time-2 (P = 0.001) but not between Baseline and Time-2. Sustained significant increases were observed in IPAQ (P = 0.001) and protein intake (P = 0.001). There were no significant changes in FFM or body fat. ESR (P = 0.002), DAS28 (P < 0.001), HAQ (P < 0.001) and TNF-{alpha} (P = 0.024) improved significantly. Physical activity (P = 0.001) and protein intake (P = 0.024) were significant between-subject factors for the elevation of REE. Conclusions. After 12 weeks of anti-TNF-{alpha} therapy, there were significant improvements in disease activity and physical function, as well as physical activity and protein intake, but no significant changes in REE or FFM. There is a need for longer-term studies in this field.
Type: Article
Language: en
Keywords: Anti-TNF-{alpha}
Resting energy expenditure
Rheumatoid Cachexia
Rheumatoid Arthritis
Adipose Tissue
Biological therapy
Arthritis, Rheumatoid
ISSN: 14620324
Appears in Collections: Sport, Exercise and Health Research Group
Exercise and Health
Learning and Teaching in Sport, Exercise and Performance

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