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01-12-2020 | Underweight | Original Article

Cachexia in patients with rheumatoid arthritis: a cohort study

Authors: Rafaela CE Santo, Jordana MS Silva, Priscila S Lora, Ana Laura D Moro, Eduarda C Freitas, Bárbara J Bartikoski, Nicole PB Andrade, Penélope E Palominos, Vanessa Hax, Tayane M Fighera, Poli Mara Spritzer, Claiton V Brenol, Rafael MS Chakr, Lidiane I Filippin, Joshua F Baker, Ricardo M Xavier

Published in: Clinical Rheumatology | Issue 12/2020

Abstract

Background

Rheumatoid arthritis (RA) is an inflammatory disease that leads to altered body composition. The loss of lean mass with a preservation or increase in fat mass has been termed rheumatoid cachexia (RC), to contrast with classic cachexia, which is characterized by severe weight loss. There are limited data on the prevalence and progression of cachexia in RA over time, as well as on associated factors. Our aim was to determine the prevalence of cachexia and to determine associations with potential factors.

Methods

This prospective cohort study recruited consecutively patients diagnosed with RA and followed for 1 year. The assessments were performed: clinical features, body composition, and physical function. RC and classic cachexia were assessed by several established diagnostic criteria. The pairwise Student’s t test, Chi-square test, and GEE were performed (accepted at p ≤ 0.05).

Results

Of 90 patients recruited, 81 completed the study. Most patients were women (88.9%), and the mean age was 56.5 ± 7.3 years. At baseline, the median DAS28-CRP was 3.0 (IQR, 1.0–3.0), 13.3–30.0% of the included patients had RC, while none met criteria for classic cachexia. The prevalence of cachexia did not change after 12 months. Disease activity status and treatment with biologic disease-modifying antirheumatic drugs were significantly associated with changes on body composition and physical function (p < 0.05).

Conclusions

In this cohort, RC was common, while classic cachexia was absent. Disease activity and use of biologic therapies were associated with changes on body composition and physical function, underscoring the importance of aiming for remission when treating RA.

Key Points

• Rheumatoid cachexia is common in RA patients.

• Classical cachexia is not often in RA patients.

• Disease activity and use of biologic therapies are associated with changes on body composition and physical function.

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Title: Cachexia in patients with rheumatoid arthritis: a cohort study
Authors: Rafaela CE Santo
Jordana MS Silva
Priscila S Lora
Ana Laura D Moro
Eduarda C Freitas
Bárbara J Bartikoski
Nicole PB Andrade
Penélope E Palominos
Vanessa Hax
Tayane M Fighera
Poli Mara Spritzer
Claiton V Brenol
Rafael MS Chakr
Lidiane I Filippin
Joshua F Baker
Ricardo M Xavier
Publication date: 01-12-2020
Publisher: Springer International Publishing
Keywords: Underweight
Underweight
Rheumatoid Arthritis
Published in: Clinical Rheumatology / Issue 12/2020
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-020-05119-y

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