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Blockade of tumour necrosis factor-alpha in rheumatoid arthritis: effects on components of rheumatoid cachexia.
Rheumatology (Oxford). 2007 Dec; 46(12):1824-7.R

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.

Authors+Show Affiliations

School of Sport, Performing Arts and Leisure, University of Wolverhampton, Walsall, West Midlands, UK. gm@wlv.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18032540

Citation

Metsios, G S., et al. "Blockade of Tumour Necrosis Factor-alpha in Rheumatoid Arthritis: Effects On Components of Rheumatoid Cachexia." Rheumatology (Oxford, England), vol. 46, no. 12, 2007, pp. 1824-7.
Metsios GS, Stavropoulos-Kalinoglou A, Douglas KM, et al. Blockade of tumour necrosis factor-alpha in rheumatoid arthritis: effects on components of rheumatoid cachexia. Rheumatology (Oxford). 2007;46(12):1824-7.
Metsios, G. S., Stavropoulos-Kalinoglou, A., Douglas, K. M., Koutedakis, Y., Nevill, A. M., Panoulas, V. F., Kita, M., & Kitas, G. D. (2007). Blockade of tumour necrosis factor-alpha in rheumatoid arthritis: effects on components of rheumatoid cachexia. Rheumatology (Oxford, England), 46(12), 1824-7.
Metsios GS, et al. Blockade of Tumour Necrosis Factor-alpha in Rheumatoid Arthritis: Effects On Components of Rheumatoid Cachexia. Rheumatology (Oxford). 2007;46(12):1824-7. PubMed PMID: 18032540.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blockade of tumour necrosis factor-alpha in rheumatoid arthritis: effects on components of rheumatoid cachexia. AU - Metsios,G S, AU - Stavropoulos-Kalinoglou,A, AU - Douglas,K M J, AU - Koutedakis,Y, AU - Nevill,A M, AU - Panoulas,V F, AU - Kita,M, AU - Kitas,G D, PY - 2007/11/23/pubmed PY - 2008/1/12/medline PY - 2007/11/23/entrez SP - 1824 EP - 7 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 46 IS - 12 N2 - 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. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/18032540/Blockade_of_tumour_necrosis_factor_alpha_in_rheumatoid_arthritis:_effects_on_components_of_rheumatoid_cachexia_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kem291 DB - PRIME DP - Unbound Medicine ER -