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    Blockade of tumour necrosis factor-{alpha} in rheumatoid arthritis: effects on components of rheumatoid cachexia

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    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.
    Issue Date
    2007
    
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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.
    Citation
    Rheumatology, 46(12): 1824-1827
    Publisher
    Oxford University Press (Oxford Journals)
    Journal
    Rheumatology
    URI
    http://hdl.handle.net/2436/35393
    DOI
    10.1093/rheumatology/kem291
    Additional Links
    http://rheumatology.oxfordjournals.org/cgi/content/abstract/46/12/1824
    Type
    Journal article
    Language
    en
    ISSN
    14620324
    14602172
    ae974a485f413a2113503eed53cd6c53
    10.1093/rheumatology/kem291
    Scopus Count
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      Rheumatoid Arthritis is Associated with IgG Antibodies to Human Endogenous Retrovirus Gag Matrix: A Potential Pathogenic Mechanism of Disease?

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