title: Cachexia and adiposity in rheumatoid arthritis. Relevance for disease management and clinical outcomes.
abstract: Altered body composition is a frequent finding in rheumatoid arthritis and is associated with the two major outcomes of the disease: disability and cardiovascular mortality. It is estimated that up to two thirds of patients may be affected by loss of lean mass, the so-called rheumatoid cachexia. Hence, body weight being equal, the relative amount of lean mass is lower and that of body fat is higher in rheumatoid arthritis patients vs. healthy controls. Both disease-related factors and other factors, like drug treatments, physical activity and nutrition contribute to modify body composition in rheumatoid arthritis. The effect of pharmacological treatments, and notably of anti-TNF drugs, on body composition is controversial. Conversely, training programs to stimulate muscle growth can restore lean mass and reduce adiposity. There is good evidence that amelioration of body composition ameliorates function and reduces disability. Currently, there is no evidence that interventions that modify body composition can reduce cardiovascular morbidity and mortality in rheumatoid arthritis.
authors.affiliation: Service de rhumatologie, hôpital Jean-Verdier-René-Muret, groupe hospitalier Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93000 Bobigny, France.
authors.forename: Salima
authors.initials: S
authors.lastname: Challal
authors.affiliation: Service de rhumatologie, hôpital Jean-Verdier-René-Muret, groupe hospitalier Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93000 Bobigny, France.
authors.forename: Emeline
authors.initials: E
authors.lastname: Minichiello
authors.affiliation: Service de rhumatologie, hôpital Jean-Verdier-René-Muret, groupe hospitalier Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93000 Bobigny, France; Inserm UMR 1125, Sorbonne Paris Cité-université Paris 13, 74, rue Marcel-Cachin, 93000 Bobigny, France.
authors.forename: Marie-Christophe
authors.initials: MC
authors.lastname: Boissier
authors.affiliation: Service de rhumatologie, hôpital Jean-Verdier-René-Muret, groupe hospitalier Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93000 Bobigny, France; Inserm UMR 1125, Sorbonne Paris Cité-université Paris 13, 74, rue Marcel-Cachin, 93000 Bobigny, France. Electronic address: luca.semerano@avc.aphp.fr.
authors.forename: Luca
authors.initials: L
authors.lastname: Semerano
mesh_terms: D050154:Adiposity / Q000502:physiology*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D002100:Cachexia / Q000209:etiology / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D006233:Persons with Disabilities; D019468:Disease Management; D015444:Exercise / Q000502:physiology; D006801:Humans; D016896:Treatment Outcome
keywords: Body composition; Cachexia; Cardiovascular disease; Disability; Frailty; Rheumatoid arthritis