Patients with rheumatoid arthritis (RA) may continue to suffer from cachexia, even when treatment successfully controls disease activity and stops progression. Findings from a recent study were reported at the 2015 British Society for Rheumatology Autumn Conference, October 15–16, in Birmingham, England.
Cachexia in RA refers to loss of muscle mass and strength. Cachexia is fairly common among people with RA—about two thirds of patients suffer from the complication. The condition can make the tiredness and achiness of RA even worse and make it difficult to function. Cachexia can also lead to serious complications, such as heart disease.
To measure the rate of cachexia among people with RA, researchers in the United Kingdom compared body composition between patients with RA with individuals without RA (controls). They found that the RA patients were more likely to have less lean body mass (muscle) and more body fat. Compared with the controls, RA patients had 11% less lean mass. RA patients also had 15% more total body fat.
The researchers then questioned whether treatment to better control the inflammation associated with RA could prevent the loss in lean mass and gain in body fat among RA patients. After a period of treatment, they measured the RA patients’ body composition as well as physical strength and ability with different exercises. Again, they compared findings for the RA group with age- and sex-matched controls.
Even after treatment to better control inflammation, the RA group still had a lower percentage of lean body mass and more body fat in their upper bodies. Overall, the RA patients also had a higher body mass index.
The RA patients also showed lower strength and physical function, as determined on the exercise tests. Their physical ability appeared about 25–30% lower than the controls.
The length of time that the RA patients had had the disease did not appear to affect body composition and physical function. In other words, those who had been living for longer periods with RA did not have less lean body mass and strength compared with those who recently developed the disease.
According to this study, patients with RA are at risk for losing muscle, gaining body fat, and losing strength and physical ability. Treatment to control inflammation in RA does not appear to help maintain lean body mass or physical function. It appears that additional treatment is needed to address cachexia in RA patients.
Reference: Lemmey A, et al. Treat-to-target treatment fails to restore either body composition or objectiveldy assessed physical function in rheumatoid arthritis patients. British Society for Rheumatology 2015; Abstract 070.