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Teixeira VON, Bartikoski BJ, do Espirito Santo RC, Alabarse PVG, Ghannan K, Silva JMS, Filippin LI, Visioli F, Martinez-Gamboa L, Feist E, Xavier RM. The role of proteasome in muscle wasting of experimental arthritis. Adv Rheumatol 2023; 63:14. [PMID: 36949513 DOI: 10.1186/s42358-023-00292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/05/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis is an autoimmune inflammatory disease that often leads patients to muscle impairment and physical disability. This study aimed to evaluate changes in the activity of proteasome system in skeletal muscles of mice with collagen-induced arthritis (CIA) and treated with etanercept or methotrexate. METHODS Male DBA1/J mice were divided into four groups (n = 8 each): CIA-Vehicle (treated with saline), CIA-ETN (treated with etanercept, 5.5 mg/kg), CIA-MTX (treated with methotrexate, 35 mg/kg) and CO (healthy control group). Mice were treated two times a week for 6 weeks. Clinical score and hind paw edema were measured. Muscles were weighted after euthanasia and used to quantify proteasome activity, gene (MuRF-1, PMSα4, PSMβ5, PMSβ6, PSMβ7, PSMβ8, PSMβ9, and PSMβ10), and protein (PSMβ1, PSMβ5, PSMβ1i, PSMβ5i) expression of proteasome subunits. RESULTS Both treatments slowed disease development, but only CIA-ETN maintained muscle weight compared to CIA-MTX and CIA-Vehicle groups. Etanercept treatment showed caspase-like activity of 26S proteasome similar to CO group, while CIA-Vehicle and CIA-MTX had higher activity compared to CO group (p: 0.0057). MuRF-1 mRNA expression was decreased after etanercept administration compared to CIA-Vehicle and CO groups (p: 0.002, p: 0.007, respectively). PSMβ8 and PSMβ9 mRNA levels were increased in CIA-Vehicle and CIA-MTX compared to CO group, while CIA-ETN presented no difference from CO. PMSβ6 mRNA expression was higher in CIA-Vehicle and CIA-MTX groups than in CO group. Protein levels of the PSMβ5 subunit were increased in CO group compared to CIA-Vehicle; after both etanercept and methotrexate treatments, PSMβ5 expression was higher than in CIA-Vehicle group and did not differ from CO group expression (p: 0.0025, p: 0.001, respectively). The inflammation-induced subunit β1 (LMP2) was enhanced after methotrexate treatment compared to CO group (p: 0.043). CONCLUSIONS The results of CIA-Vehicle show that arthritis increases muscle proteasome activation by enhanced caspase-like activity of 26S proteasome and increased PSMβ8 and PSMβ9 mRNA levels. Etanercept treatment was able to maintain the muscle weight and to modulate proteasome so that its activity and gene expression were compared to CO after TNF inhibition. The protein expression of inflammation-induced proteasome subunit was increased in muscle of CIA-MTX group but not following etanercept treatment. Thus, anti-TNF treatment may be an interesting approach to attenuate the arthritis-related muscle wasting.
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Affiliation(s)
- Vivian Oliveira Nunes Teixeira
- Medical Sciences Program, Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratório de Doenças Autoimunes, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, Santa Cecília, Porto Alegre, 2350, Brazil
| | - Bárbara Jonson Bartikoski
- Medical Sciences Program, Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratório de Doenças Autoimunes, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, Santa Cecília, Porto Alegre, 2350, Brazil
| | - Rafaela Cavalheiro do Espirito Santo
- Medical Sciences Program, Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Laboratório de Doenças Autoimunes, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, Santa Cecília, Porto Alegre, 2350, Brazil.
| | - Paulo Vinícius Gil Alabarse
- Medical Sciences Program, Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratório de Doenças Autoimunes, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, Santa Cecília, Porto Alegre, 2350, Brazil
- University of California San Diego Medical Center Library, University of California San Diego School of Medicine, San Diego, USA
| | - Khetam Ghannan
- Schwerpunkt Rheumatologie und Klinische Immunologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jordana Miranda Souza Silva
- Medical Sciences Program, Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratório de Doenças Autoimunes, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, Santa Cecília, Porto Alegre, 2350, Brazil
| | - Lidiane Isabel Filippin
- Laboratório de Doenças Autoimunes, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, Santa Cecília, Porto Alegre, 2350, Brazil
- Health and Human Development Department, Universidade La Salle, Canoas, Brazil
| | - Fernanda Visioli
- Patology Department, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lorena Martinez-Gamboa
- Schwerpunkt Rheumatologie und Klinische Immunologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eugen Feist
- Schwerpunkt Rheumatologie und Klinische Immunologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ricardo Machado Xavier
- Medical Sciences Program, Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratório de Doenças Autoimunes, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, Santa Cecília, Porto Alegre, 2350, Brazil
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de Souza MPGU, Guimarães NS, de Resende Guimarães MFB, de Souza VA, Kakehasi AM. Effect of biological disease-modifying antirheumatic drugs on body composition in patients with rheumatoid arthritis: a systematic review and meta-analysis. Adv Rheumatol 2022; 62:16. [DOI: 10.1186/s42358-022-00249-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 05/17/2022] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Rheumatoid arthritis (RA) generates an inflammatory profile that predisposes to total and visceral fatty accumulation and reduced fat free mass (FFM). This metabolic disorder contributes to poor functionality, increased cardiovascular risk and higher mortality. This study aimed to address a systematic review with meta-analysis to determine the effect of biological and targeted synthetic disease-modifying antirheumatic drugs (bDMARDs and tsDMARDs) on body composition (BC) of patients with RA.
Methods
The search was conducted at the electronic databases PubMed, Cochrane Library, Embase, Lilacs and grey literature. This investigation was carried until July 2021. Outcomes of interest were total weight, body mass index (BMI), fat mass (FM) and FFM. A meta-analysis comparing these outcomes in RA patients under bDMARD treatment versus controls was performed.
Results
Out of 137 studies reviewed, 18 were selected: fifteen prospective cohorts, two retrospective cohorts, and one cross-sectional study. The studies comprised 1221 patients, 778 on bDMARD treatment and 443 controls, which included RA patients under conventional synthetic DMARD (csDMARD). No study addressing BC analysis in patients using tsDMARD was found. The mean age and duration of the disease was 56.7 years and 6.77 years, respectively. Ten studies demonstrated a significant increase of total weight in 88.2% of patients and 42.3% for BMI. In studies that analyzed BC by double X-ray absorptiometry (DXA), the increase in total weight and BMI correlated positively to the increase in FFM. The meta-analysis carried out in five studies showed no significant difference of the mean difference for total weight 0.12 kg (95% CI − 5.58, 5.82), BMI 0.08 kg/m2 (95% CI − 1.76, 1.92), FM − 0.08 kg (95% IC − 5.31, 5.14), and FFM − 2.08 kg (95% CI − 7.37, 3.21).
Conclusion
This systematic review suggests a possible impact of bDMARDs on BC of RA patients, even though, the meta-analysis carried out in a small part of these studies was not able to confirm significant variation in BC components.
Trial registration: PROSPERO code: CRD42020206949.
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Sellam J, Morel J, Tournadre A, Bouhnik Y, Cornec D, Devauchelle-Pensec V, Dieudé P, Goupille P, Jullien D, Kluger N, Lazaro E, Le Goff B, de Lédinghen V, Lequerré T, Nocturne G, Seror R, Truchetet ME, Verhoeven F, Pham T, Richez C. PRACTICAL MANAGEMENT of patients on anti-TNF therapy: Practical guidelines drawn up by the Club Rhumatismes et Inflammation (CRI). Joint Bone Spine 2021; 88:105174. [PMID: 33992225 DOI: 10.1016/j.jbspin.2021.105174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jérémie Sellam
- Service de Rhumatologie, CHU Saint-Antoine, Paris, France
| | - Jacques Morel
- Service de Rhumatologie, CHU Montpellier, Montpellier, France
| | - Anne Tournadre
- Service de Rhumatologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Yoram Bouhnik
- Service de Gastro-entérologie, CHU Hôpital Beaujon, Clichy, France
| | - Divi Cornec
- Service de Rhumatologie, CHRU La Cavale Blanche, Brest, France
| | | | - Philippe Dieudé
- Service de Rhumatologie, CHU Bichat-Claude Bernard, Paris, France
| | | | | | - Nicolas Kluger
- Dpt Dermatology, Helsinki, Finland; Service de Dermatologie, CHU Bichat-Claude Bernard, Paris, France
| | - Estibaliz Lazaro
- Service de Médecine interne, Hôpital Haut-Lévêque, CHU Bordeaux, Pessac, France
| | | | - Victor de Lédinghen
- Unité d'Hépatologie et transplantation hépatique, Hôpital Haut-Lévêque, CHU Bordeaux, Pessac, France
| | | | | | - Raphaèle Seror
- Service de Rhumatologie, Bicêtre, Le Kremlin-Bicêtre, France
| | | | | | - Thao Pham
- Service de Rhumatologie, CHU Sainte-Marguerite, Marseille, France
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4
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Morel J, Tournadre A, Sellam J, Bouhnik Y, Cornec D, Devauchelle-Pensec V, Dieudé P, Goupille P, Kluger N, Lazaro E, Le Goff B, de Lédinghen V, Lequerré T, Nocturne G, Seror R, Truchetet ME, Verhoeven F, Pham T, Richez C. Practical Management of patients on anti-IL6R therapy: Practical guidelines drawn up by the Club Rhumatismes et Inflammation (CRI). Joint Bone Spine 2021; 88:105221. [PMID: 34183155 DOI: 10.1016/j.jbspin.2021.105221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jacques Morel
- Service de Rhumatologie, CHU Montpellier, Montpellier, France
| | - Anne Tournadre
- Service de Rhumatologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Jérémie Sellam
- Service de Rhumatologie, CHU Saint-Antoine, Paris, France
| | - Yoram Bouhnik
- Service de Gastro-entérologie, CHU Hôpital Beaujon, Clichy, France
| | - Divi Cornec
- Service de Rhumatologie, CHRU La Cavale Blanche, Brest, France
| | | | - Philippe Dieudé
- Service de Rhumatologie, CHU Bichat-Claude Bernard, Paris, France
| | | | - Nicolas Kluger
- Dpt Dermatology, Helsinki, Finland & Service de Dermatologie, CHU Bichat-Claude Bernard, Paris, France
| | - Estibaliz Lazaro
- Service de Médecine interne, Hôpital Haut-Lévêque, CHU Bordeaux, Pessac, France
| | | | - Victor de Lédinghen
- Unité d'Hépatologie et transplantation hépatique, Hôpital Haut-Lévêque, CHU Bordeaux, Pessac, France
| | | | | | - Raphaèle Seror
- Service de Rhumatologie, Bicêtre, Le Kremlin-Bicêtre, France
| | | | | | - Thao Pham
- Service de Rhumatologie, CHU Sainte-Marguerite, Marseille, France
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Vuolteenaho K, Tuure L, Nieminen R, Laasonen L, Leirisalo-Repo M, Moilanen E. Pretreatment resistin levels are associated with erosive disease in early rheumatoid arthritis treated with disease-modifying anti-rheumatic drugs and infliximab. Scand J Rheumatol 2021; 51:180-185. [PMID: 34263700 DOI: 10.1080/03009742.2021.1929456] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: Resistin is an adipocytokine related to insulin resistance and inflammation. We investigated whether resistin is associated with disease activity and inflammation in disease-modifying anti-rheumatic drug (DMARD)-naïve rheumatoid arthritis (RA) patients, whether it has predictive value for radiological disease progression, and whether tumour necrosis factor-α (TNF-α) is involved in these effects.Method: Ninety-nine patients with early, DMARD-naïve RA participated in the NEO-RACo study. Patients were treated for the first 4 weeks with a combination of methotrexate, sulfasalazine, hydroxychloroquine, and prednisolone (FIN-RACo treatment). Thereafter, they were randomized to receive either infliximab or placebo added to the combination for 6 months. Patients were followed for 5 years. Disease activity was evaluated using the Disease Activity Score based on 28-joint count-erythrocyte sedimentation rate, radiographs were scored with the modified Sharp-van der Heijde method, and plasma resistin concentrations were measured by immunoassay. Human THP-1 macrophages were used in the in vitro studies.Results: A high resistin level at baseline was associated with active inflammatory disease and predicted more rapid radiological progression during 5 year follow-up. Adding infliximab to the DMARD combination delayed radiological progression and overcame the poor predictive value of resistin. Resistin increased TNF-α production in human macrophages, indicating a possible connection between resistin and TNF-α.Conclusion: The results suggest that high resistin concentration may be a useful marker to distinguish patients with an increased risk of erosive disease in early active RA, and that adding TNF-α antagonist to the traditional DMARD combination may delay radiological progression of the disease in these patients.The study has been registered at https://www.clinicaltrials.gov (NCT00908089).
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Affiliation(s)
- K Vuolteenaho
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - L Tuure
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - R Nieminen
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - L Laasonen
- Helsinki Medical Imaging Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - M Leirisalo-Repo
- Rheumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - E Moilanen
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
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Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview. Nutrients 2021; 13:nu13020656. [PMID: 33671473 PMCID: PMC7922969 DOI: 10.3390/nu13020656] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
Malnutrition is a common condition encountered in patients with inflammatory bowel disease (IBD) and is often associated with sarcopenia (the reduction of muscle mass and strength) which is an ever-growing consideration in chronic diseases. Recent data suggest the prevalence of sarcopenia is 52% and 37% in Crohn's disease and ulcerative colitis, respectively, however it is challenging to fully appreciate the prevalence of sarcopenia in IBD. Sarcopenia is an important consideration in the management of IBD, including the impact on quality of life, prognostication, and treatment such as surgical interventions, biologics and immunomodulators. There is evolving research in many chronic inflammatory states, such as chronic liver disease and rheumatoid arthritis, whereby interventions have begun to be developed to counteract sarcopenia. The purpose of this review is to evaluate the current literature regarding the impact of sarcopenia in the management of IBD, from mechanistic drivers through to assessment and management.
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Borren NZ, Tan W, Jess AT, Li PHM, Garber JJ, Luther J, Colizzo FP, Khalili H, Ananthakrishnan AN. Assessment of Body Weight Changes in Patients with Inflammatory Bowel Diseases Initiating Biologic Therapy: A Prospective Cohort Study. Dig Dis Sci 2020; 65:3672-3678. [PMID: 32617768 DOI: 10.1007/s10620-020-06442-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/21/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Prior studies have inconsistently suggested that biologic therapy may be associated with weight gain in inflammatory bowel disease patients (IBD). Our aim was to compare weight gain across different biologic therapy classes with distinct mechanisms of action. METHODS This prospective cohort study recruited patients with moderate to severe IBD initiating outpatient biologic therapy with anti-TNF (infliximab, adalimumab), vedolizumab, or ustekinumab. Weight measurements were performed at weeks 0, 14, 30, and 54. Changes in weight between baseline and each of the follow-up visits were modeled as a continuous variable, and multivariate regression assessed the independent effect of therapeutic class on this outcome. RESULTS Our study enrolled 269 patients (163 CD, 106 UC) initiating biologic therapy [99 anti-TNF (37%), 122 vedolizumab (45%), 48 ustekinumab (18%)]. From baseline, the weight significantly increased at week 14 with a mean of 0.36 kg (± 3.8 kg, p = 0.004) and continued to increase compared to baseline with 0.96 kg (± 3.9 kg, p < 0.001) and 1.29 kg (± 4.2 kg, p < 0.001) at week 30 and 54, respectively. On univariate and multivariable analysis, no significant differences between any of the biologic therapies for weight gain were seen at any time point (weight gain anti-TNF: 0.31 kg, 1.06 kg, 1.33 kg; VDZ: 0.30 kg, 0.83 kg, 1.10 kg; UST: 0.63 kg, 1.21 kg, 2.31 kg at wk 14, wk 30, and wk 54, respectively). None of the disease activity parameters showed any statistical association with weight gain. CONCLUSION There was no difference in weight gain among the different biologic therapeutic classes.
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Affiliation(s)
- Nienke Z Borren
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - William Tan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alison T Jess
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Pei-Hsuan Mimi Li
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - John J Garber
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jay Luther
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Francis P Colizzo
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Hamed Khalili
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ashwin N Ananthakrishnan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. .,Massachusetts General Hospital Crohn's and Colitis Center, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA.
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Lepp J, Höög C, Forsell A, Fyrhake U, Lördal M, Almer S. Rapid weight gain in infliximab treated Crohn's disease patients is sustained over time: real-life data over 12 months. Scand J Gastroenterol 2020; 55:1411-1418. [PMID: 33108226 DOI: 10.1080/00365521.2020.1837929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Infliximab (IFX) is used in active Crohn's disease for induction and maintenance of remission. There are scanty data on weight gain in IBD-patients under anti-TNF treatment. We investigated changes in weight and blood chemistry in anti-TNF-naïve Crohn's disease patients during their first course of IFX. METHODS Retrospective analysis of 110 patients (77 men, 33 women) aged 34 years (range 14-73), 54 with luminal and 56 with fistulising disease, given at least 3 infusions of IFX (range 3-11). Data regarding body weight, height, C-reactive protein (CRP), haemoglobin and S-albumin at baseline, before the third infusion, at three months and at 12 months were collected. RESULTS At 6 weeks, 65 (59%) increased in weight, 73% and 76% at three and 12 months, respectively. There was an increase in median weight (1.7 kg, IQR = 3.1 kg) and BMI (0.5 kg/m2, IQR = 1.2 kg/m2) at 6 weeks, which persisted at three and 12 months (all p < .001). There was no difference between men and women. Young patients, patients with underweight or fistulising disease increased most in weight. Disease activity assessed by PGA and SES-CD decreased at all time points (p < .05). Increases in weight and BMI correlated with an increase in serum albumin and a decrease in CRP. CONCLUSION Approximately 60% of Crohn's disease patients experience weight gain within the first six weeks of infliximab treatment. The weight increment correlates with improvements in inflammatory markers and disease activity. The causes of weight gain may be related to treatment induced metabolic changes and reduced inflammatory burden.
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Affiliation(s)
- Johanna Lepp
- Department of Medicine, Karolinska Institutet, Solna, Sweden
| | - Charlotte Höög
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden.,GHP Stockholm Gastro Center, Stockholm, Sweden
| | - Anette Forsell
- Department of Medicine, Ersta Hospital, Stockholm, Sweden
| | - Ulrika Fyrhake
- Division of Gastroenterology, Karolinska University Hospital, Stockholm, Sweden
| | - Mikael Lördal
- GI-unit, Department of Medicine, Danderyd Hospital, Danderyd, Sweden
| | - Sven Almer
- Department of Medicine, Karolinska Institutet, Solna, Sweden.,Division of Gastroenterology, Karolinska University Hospital, Stockholm, Sweden
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Johansson EK, Ivert LU, Bradley B, Lundqvist M, Bradley M. Weight gain in patients with severe atopic dermatitis treated with dupilumab: a cohort study. BMC DERMATOLOGY 2020; 20:8. [PMID: 32962676 PMCID: PMC7510313 DOI: 10.1186/s12895-020-00103-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a cohort study of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching. METHODS All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This cohort constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10 cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value < 0.05 considered as statistically significant. RESULTS Patients treated with dupilumab (n = 12) gained weight (mean 6.1 kg, range [0.1-18.0], p = 0.002) after 1 year on treatment. The majority of patients showed a good response to treatment with dupilumab (n = 11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n = 6), EASI-75 (n = 4), or EASI-50 (n = 1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n = 8). CONCLUSIONS To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.
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Affiliation(s)
- Emma Kristin Johansson
- Dermatology and Venereology Unit, Department of Medicine Solna, Karolinska Institutet, SE-171 77, Stockholm, Sweden. .,Dermatological and Venereal Clinic, Södersjukhuset, SE-118 83, Stockholm, Sweden.
| | - Lina Ulrika Ivert
- Dermatology and Venereology Unit, Department of Medicine Solna, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Department of Dermatology, Karolinska University Hospital Solna, SE-171 76, Stockholm, Sweden
| | - Baltzar Bradley
- Department of Dermatology, Karolinska University Hospital Solna, SE-171 76, Stockholm, Sweden
| | - Maria Lundqvist
- Department of Dermatology, Karolinska University Hospital Solna, SE-171 76, Stockholm, Sweden
| | - Maria Bradley
- Dermatology and Venereology Unit, Department of Medicine Solna, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Department of Dermatology, Karolinska University Hospital Solna, SE-171 76, Stockholm, Sweden
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Iqbal SM, Burns L, Grisanti J. Effect of Body Mass Index on the Disease Activity of Patients With Rheumatoid Arthritis in a Gender-Specific Manner and the Association of Respective Serum C-Reactive Protein Levels With the Body's Inflammatory Status. Cureus 2020; 12:e9417. [PMID: 32864245 PMCID: PMC7449617 DOI: 10.7759/cureus.9417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Current literature evaluating the effect of high body mass index (BMI) on the disease activity of patients with rheumatoid arthritis (RA) is mixed as some studies have shown a positive, linear relationship between BMI and disease activity while others have demonstrated an inverse correlation. Through this study, we have expanded the effect of BMI on disease activity in patients with RA. We have further expanded on whether BMI influences the disease activity depending on the gender being studied. Finally, we have studied whether there is a correlation between high BMI values and rising C-reactive protein (CRP) levels. Methodology This cross-sectional study was conducted at the Outpatient Clinical Department of Buffalo Rheumatology. The study was ethically approved by the Catholic Health Institutional Review Board. A total number of 451 patients' clinical data was selected based on inclusion/exclusion criteria. The patients were divided into different BMI categories based on the guidelines of national obesity education initiative of the national heart, lung, and blood Institute. The following clinical parameters were studied: BMI, serum CRP level, and disease activity through routine assessment of patient index data questionnaire 3 (RAPID3). The minimum sample size (n = 358) was calculated via the world health organization sample size calculator. All data were entered and analyzed through Statistical Package for the Social Sciences (SPSS), version 16.0 (IBM Corp., Armonk, NY). Results Our study sample included 98 males and 353 females (22% and 78%, respectively). Collective data for both the genders showed significantly increased disease activity in RA patients with high BMI values (p = 0.04). When the data sets were categorized according to the two genders, it was noted that the aforementioned results remain significant for the females only (p = 0.02 for females and p = 0.57 for males). At all BMI values, mean RAPID3 scoring remained significantly higher for females as opposed to their male counterparts (p = 0.006). Mean serum CRP levels increased linearly with increasing BMI (p < 0.001); however, for the underweight patient population, mean CRP levels were the highest as compared to normal weight, overweight, moderately obese, and severely obese patients. Conclusion We conclude that the association between the BMI and the severity of disease remains elusive. High BMI values increase the risk of a pro-inflammatory state of the body due to higher serum CRP levels. Estimating the clinically significant benefit of this theory would require a large-scale clinical trial that would highlight the role of losing weight in improving the patients' quality of life, pain control, and mortality.
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Affiliation(s)
- Shumaila M Iqbal
- Internal Medicine, University at Buffalo/Sisters of Charity Hospital, Buffalo, USA
| | - Linda Burns
- Rheumatology, Buffalo Rheumatology and Medicine, Buffalo, USA
| | - Joseph Grisanti
- Rheumatology, Buffalo Rheumatology and Medicine, Buffalo, USA
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11
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Patsalos O, Dalton B, Leppanen J, Ibrahim MAA, Himmerich H. Impact of TNF-α Inhibitors on Body Weight and BMI: A Systematic Review and Meta-Analysis. Front Pharmacol 2020; 11:481. [PMID: 32351392 PMCID: PMC7174757 DOI: 10.3389/fphar.2020.00481] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 03/27/2020] [Indexed: 12/12/2022] Open
Abstract
Objective The aim of this systematic review and meta-analysis of longitudinal studies was to ascertain to effects of TNF-α inhibitor therapy on body weight and BMI. Methods Three databases (PubMed, OVID, and EMBASE) were systematically searched from inception to August 2018. We identified prospective, retrospective, and randomized controlled studies in adults with immune-mediated inflammatory diseases treated with TNF-α inhibitors based on pre-specified inclusion criteria. A random-effects model was used to estimate standardised mean change (SMCC). Results Twenty-six longitudinal studies with a total of 1,245 participants were included in the meta-analysis. We found evidence for a small increase in body weight (SMCC = 0.24, p = .0006, 95% CI [0.10, 0.37]) and in BMI (SMCC = 0.26, p < .0001, 95% CI [0.13, 0.39]). On average, patients gained 0.90kg (SD = 5.13) under infliximab, 2.34kg (D = 5.65) under etanercept and 2.27kg (SD = 4.69) during treatment with adalimumab within the duration of the respective studies (4–104 weeks). Conclusion Our results yield further support the for the view that TNF-α inhibitors increase body weight and BMI as a potential side effect. Modulating cytokine signaling could be a future therapeutic mechanism to treat disorders associated with weight changes such as anorexia nervosa.
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Affiliation(s)
- Olivia Patsalos
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Bethan Dalton
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Jenni Leppanen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Mohammad A A Ibrahim
- Department of Clinical Immunological Medicine and Allergy, King's Health Partners, King's College Hospital, London, United Kingdom
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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12
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Winter RW, Friedman S. Understanding the Cause of Weight Gain in Patients With IBD on Anti-TNF Medications. Inflamm Bowel Dis 2020; 26:132-133. [PMID: 31265724 DOI: 10.1093/ibd/izz134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Indexed: 12/09/2022]
Abstract
This article investigates the factors that are associated with weight gain in patients on anti–tumor necrosis factor (anti-TNF) medications. What remains unanswered is whether remission of disease activity, the anti-TNF medications themselves, or both are responsible for abnormal weight gain in patients with inflammatory bowel disease.
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Affiliation(s)
- Rachel W Winter
- Center for Crohn's and Colitis, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Chestnut Hill, Massachusetts, USA
| | - Sonia Friedman
- Center for Crohn's and Colitis, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Chestnut Hill, Massachusetts, USA
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13
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Christian KE, Russman KM, Rajan DP, Barr EA, Cross RK. Gender Differences and Other Factors Associated with Weight Gain Following Initiation of Infliximab: A Post Hoc Analysis of Clinical Trials. Inflamm Bowel Dis 2020; 26:125-131. [PMID: 31265730 DOI: 10.1093/ibd/izz133] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND In our clinical practice, women often report excess weight gain with infliximab (IFX) use. There are currently no studies investigating weight gain after antitumor necrosis factor therapy in patients with inflammatory bowel disease. The objective of this study was to evaluate the association of clinical factors, with a particular focus on sex and weight gain in patients with moderate to severe Crohn's disease (CD) or ulcerative colitis (UC) initiating IFX. METHODS Data was extracted from ACCENT I, ACCENT II, ACT 1, and SONIC; included patients received IFX for induction or maintenance of remission of CD or UC. Patients treated with azathioprine (IFX 0 mg/kg) were included as controls. Baseline demographics, clinical characteristics, and weight at each follow-up for the study duration were collected. In addition to descriptive statistics, adjusted mixed effects models were used to test the association between clinical variables and weight gain. RESULTS There were 1273 patients included for analysis; the majority was white (91%), with CD (81%), and half of patients (50%) were women. Upon univariate analysis, IFX dose, African American race, diagnosis of CD, elevated C-reactive protein, and low hematocrit and albumin were associated with weight gain (P < 0.001). Upon adjusted analysis, sex was significantly associated with weight gain (P = 0.009), with women experiencing a lower percentage increase from baseline weight than men (3.9% increase vs 4.3% increase). CONCLUSIONS When starting IFX, those with markers of severe disease and with a diagnosis of CD are likely to gain more weight. Adjusting for confounding variables, women actually gain less weight than men after IFX treatment, although this difference is not clinically relevant.
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Affiliation(s)
- Kaci E Christian
- University of Maryland School of Medicine, Division of Gastroenterology and Hepatology
| | - Katharine M Russman
- University of Maryland School of Medicine, Division of Gastroenterology and Hepatology
| | - Dhyan P Rajan
- University of Maryland School of Medicine, Division of Gastroenterology and Hepatology
| | - Erik A Barr
- University of Maryland School of Medicine, Department of Epidemiology and Public Health
| | - Raymond K Cross
- University of Maryland School of Medicine, Division of Gastroenterology and Hepatology
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14
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Novikova DS, Udachkina HV, Markelova EI, Kirillova IG, Misiyuk AS, Demidova NV, Popkova TV. Dynamics of body mass index and visceral adiposity index in patients with rheumatoid arthritis treated with tofacitinib. Rheumatol Int 2019; 39:1181-1189. [DOI: 10.1007/s00296-019-04303-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/09/2019] [Indexed: 12/31/2022]
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15
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Takamura S, Takahashi A, Inoue Y, Teraki Y. Effects of tumor necrosis factor-α, interleukin-23 and interleukin-17A inhibitors on bodyweight and body mass index in patients with psoriasis. J Dermatol 2018; 45:1130-1134. [PMID: 30004583 DOI: 10.1111/1346-8138.14526] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 06/04/2018] [Indexed: 11/28/2022]
Abstract
Treatment with tumor necrosis factor-α inhibitors has been reported to cause weight gain in patients with psoriasis; however, limited information is available in terms of the effects of interleukin (IL)-23 and IL-17A inhibitors on bodyweight (BW) in patients with psoriasis. This study aimed to investigate the effects of infliximab, ustekinumab and secukinumab on BW and body mass index (BMI) in patients with psoriasis. We retrospectively examined changes in BW and BMI among patients treated with these biologics at our hospital. At baseline, no significant differences in BW and BMI were observed among the patients treated with infliximab (n = 18), ustekinumab (n = 30) or secukinumab (n = 20). After 7 months of the therapy, significant increases in mean BW (from 71.4 to 74.3 kg) and mean BMI (from 24.7 to 25.7) were observed in the patients treated with infliximab, whereas no significant changes were observed in those treated with ustekinumab (BW, from 70.3 to 70.1 kg; BMI, from 25.4 to 25.3) or secukinumab (BW, from 69.0 to 68.9 kg; BMI, from 25.2 to 25.2). There were no differences in the proportion of the patients who showed 75% or more improvement in the Psoriasis Area and Severity Index among the three groups. These results suggest that infliximab increases BW in the patients with psoriasis, whereas ustekinumab and secukinumab do not affect the BW in these patients.
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Affiliation(s)
- Saori Takamura
- Department of Dermatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Aya Takahashi
- Department of Dermatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yumiko Inoue
- Department of Dermatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yuichi Teraki
- Department of Dermatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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16
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Biologic Agents Are Associated with Excessive Weight Gain in Children with Inflammatory Bowel Disease. Dig Dis Sci 2017; 62:3110-3116. [PMID: 28895012 DOI: 10.1007/s10620-017-4745-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/30/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Children with active inflammatory bowel disease (IBD) are frequently underweight. Anti-tumor necrosis factor (anti-TNF) agents may induce remission and restore growth. However, its use in other autoimmune diseases has been associated with excess weight gain. Our aim was to examine whether children with IBD could experience excess weight gain. METHODS A centralized diagnostic index identified pediatric IBD patients evaluated at our institution who received anti-TNF therapy for at least 1 year between August 1998 and December 2013. Anthropometric data were collected at time of anti-TNF initiation and annually. Excess weight gain was defined as ΔBMI SDS (standard deviation score) where patients were (1) reclassified from "normal" to "overweight/obese," (2) "overweight" to "obese," or (2) a final BMI SDS >0 and ΔSDS >0.5. RESULTS During the study period, 268 children received anti-TNF therapy. Of these, 69 had sufficient follow-up for a median of 29.3 months. Median age at first anti-TNF dose was 12.8 years. At baseline, mean weight SDS was -0.7 (SD 1.4), while mean BMI SDS was -0.6 (1.3). Using baseline BMI SDS, 11.6% were overweight/obese. At last follow-up (LFU), however, the mean ΔBMI SDS was 0.50 (p < 0.0001). However, 10 (17%) patients had excess weight gain at LFU; 3 patients were reclassified from "normal" to "obese," and 7 had a final BMI SDS >0 and ΔSDS >0.5. CONCLUSIONS Pediatric patients with IBD may experience excess weight gain when treated with anti-TNF agents. Monitoring for this side effect is warranted.
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Santos JCD, Malaguti C, Lucca FDA, Cabalzar AL, Ribeiro TCDR, Gaburri PD, Chebli LA, Chebli JMF. Impact of biological therapy on body composition of patients with Chron's disease. Rev Assoc Med Bras (1992) 2017; 63:407-413. [PMID: 28724037 DOI: 10.1590/1806-9282.63.05.407] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 11/20/2016] [Indexed: 12/18/2022] Open
Abstract
Introduction: Protein-energy malnutrition in Crohn's disease (CD) has been reported in 20 to 92% of patients, and is associated with increased morbidity and mortality and higher costs for the health system. Anti-TNF drugs are a landmark in the clinical management, promoting prolonged remission in patients with CD. It is believed that the remission of this disease leads to nutritional recovery. The effect of biological therapy on body composition and nutritional status is unclear. Method: Prospective study of body assessment by bioelectrical impedance method in patients with moderate to severe CD undergoing treatment with infliximab. The main outcome was the body composition before and after 6 months of anti-TNF therapy. Results: There was a predominance of females (52%) with a mean age of 42±12 years. Most patients were eutrophic at baseline and remained so. There was an increase in all parameters of body composition after anti-TNF treatment: BMI (22.9±3.2 versus 25±3.8; p=0.005), waist circumference (88.1±6.7 versus 93.9±7.7; p=0.002), lean mass index (17.5±2.2 versus 18.2±2.3; p=0.000) and fat mass index (5.5±2.3 versus 6.8±2.3; p=0.000). Phase angle remained unchanged (6.2 versus 6.8; p=0.94). Conclusion: After therapy with IFX, all components of body composition increased, except for phase angle. The substantial increase in fat mass index and waist circumference led to concern regarding cardiovascular risk and, thus, to the need for further studies.
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Affiliation(s)
- Julianne Campos Dos Santos
- Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Carla Malaguti
- Department of Cardiorespiratory and Musculoskeletal Physiotherapy, Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Fernando de Azevedo Lucca
- Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Andrea Lemos Cabalzar
- Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | - Pedro Duarte Gaburri
- Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Liliana Andrade Chebli
- Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Julio Maria Fonseca Chebli
- Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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18
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Tournadre A, Pereira B, Dutheil F, Giraud C, Courteix D, Sapin V, Frayssac T, Mathieu S, Malochet-Guinamand S, Soubrier M. Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis. J Cachexia Sarcopenia Muscle 2017; 8:639-646. [PMID: 28316139 PMCID: PMC5566648 DOI: 10.1002/jcsm.12189] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 12/22/2016] [Accepted: 01/10/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by increased mortality associated with cardiometabolic disorders including dyslipidaemia, insulin resistance, and cachectic obesity. Tumour necrosis factor inhibitors and interleukin 6 receptor blocker licensed for the treatment of RA decrease inflammation and could thus improve cardiovascular risk, but their effects on body composition and metabolic profile need to be clarified. We investigated the effects of tocilizumab (TCZ), a humanized anti-interleukin 6 receptor antibody, on body composition and metabolic profile in patients treated for RA. METHODS Twenty-one active RA patients treated with TCZ were included in a 1 year open follow-up study. Waist circumference, body mass index, blood pressure, lipid profile, fasting glucose, insulin, serum levels of adipokines and pancreatic/gastrointestinal hormones, and body composition (dual-energy X-ray absorptiometry) were measured at baseline and 6 and 12 months of treatment. At baseline, RA patients were compared with 21 non-RA controls matched for age, sex, body mass index, and metabolic syndrome. RESULTS Compared with controls, body composition was altered in RA with a decrease in total and appendicular lean mass, whereas fat composition was not modified. Among RA patients, 28.6% had a skeletal muscle mass index below the cut-off point for sarcopaenia (4.8% of controls). After 1 year of treatment with TCZ, there was a significant weight gain without changes for fat mass. In contrast, an increase in lean mass was observed with a significant gain in appendicular lean mass and skeletal muscle mass index between 6 and 12 months. Distribution of the fat was modified with a decrease in trunk/peripheral fat ratio and an increase in subcutaneous adipose tissue. No changes for waist circumference, blood pressure, fasting glucose, and atherogenic index were observed. CONCLUSIONS Despite weight gain during treatment with TCZ, no increase in fat but a modification in fat distribution was observed. In contrast, muscle gain suggests that blocking IL-6 might be efficient in treating sarcopaenia associated with RA.
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Affiliation(s)
- Anne Tournadre
- Rheumatology Department, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France.,UNH-UMR 1019, INRA, University Clermont Auvergne, 58 rue Montalembert, BP 321, 63009, Clermont-Ferrand CEDEX, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France
| | - Fréderic Dutheil
- Department of Preventive and Occupational Medicine, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France.,Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions EA3533, University Clermont Auvergne, CNRS LaPSCo, Physiological and Psychosocial Stress, 24 Avenue des Landais, 63171, Aubière, France.,Faculty of Health, Australian Catholic University, Melbourne, Victoria, Australia
| | - Charlotte Giraud
- Rheumatology Department, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France
| | - Daniel Courteix
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions EA3533, University Clermont Auvergne, CNRS LaPSCo, Physiological and Psychosocial Stress, 24 Avenue des Landais, 63171, Aubière, France.,Faculty of Health, Australian Catholic University, Melbourne, Victoria, Australia
| | - Vincent Sapin
- Biochemistry and Molecular Biology Department, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France.,University Clermont Auvergne, EA7281, 28 Place Henri-Dunant, 63001, Clermont-Ferrand, France
| | - Thomas Frayssac
- Rheumatology Department, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France
| | - Sylvain Mathieu
- Rheumatology Department, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France
| | - Sandrine Malochet-Guinamand
- Rheumatology Department, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France
| | - Martin Soubrier
- Rheumatology Department, CHU Clermont-Ferrand, 58 rue Montalembert, BP 69, 63003, Clermont-Ferrand CEDEX, France.,UNH-UMR 1019, INRA, University Clermont Auvergne, 58 rue Montalembert, BP 321, 63009, Clermont-Ferrand CEDEX, France
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19
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Baker JF, Sauer BC, Cannon GW, Teng CC, Michaud K, Ibrahim S, Jorgenson E, Davis L, Caplan L, Cannella A, Mikuls TR. Changes in Body Mass Related to the Initiation of Disease-Modifying Therapies in Rheumatoid Arthritis. Arthritis Rheumatol 2017; 68:1818-27. [PMID: 26882094 DOI: 10.1002/art.39647] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 02/11/2016] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Unintentional weight loss is important and can be predictive of long-term outcomes in patients with rheumatoid arthritis (RA). This study was undertaken to assess how primary therapies for RA may influence changes in body mass index (BMI) in RA patients from a large administrative database. METHODS Unique dispensing episodes of methotrexate, prednisone, leflunomide, and tumor necrosis factor inhibitors (TNFi) administered to RA patients were identified from the US Department of Veterans Affairs pharmacy databases. Values for C-reactive protein (CRP) level and BMI closest to the time point within 30 days of the treatment course start date and at follow-up time points were linked. Missing laboratory values were imputed. Weight loss was defined as a decrease in BMI of >1 kg/m(2) . Regression models were used to evaluate changes in BMI during each drug treatment as compared to treatment with methotrexate. To assess the impact of confounding by indication, propensity scores for use of each drug were incorporated in analyses using matched-weighting techniques. RESULTS In total, 52,662 treatment courses in 32,859 RA patients were identified. At 6 months from the date of prescription fill, weight gain was seen among patients taking methotrexate, those taking prednisone, and those taking TNFi. On average, compared to methotrexate-treated patients, prednisone-treated patients had significantly more weight gain, while leflunomide-treated patients demonstrated weight loss. In multivariable models, more weight loss (β = -0.41 kg/m(2) , 95% confidence interval [95% CI] -0.46, -0.36; P < 0.001) and a greater risk of weight loss (odds ratio 1.73, 95% CI 1.55, 1.79; P < 0.001) were evident among those receiving leflunomide compared to those receiving methotrexate. Treatment with prednisone was associated with greater weight gain (β = 0.072 kg/m(2) , 95% CI 0.042, 0.10; P < 0.001). These associations persisted in analyses adjusted for propensity scores and in sensitivity analyses. CONCLUSION Leflunomide is associated with significantly more, but modest, weight loss, while prednisone is associated with greater weight gain compared to other therapies for RA.
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Affiliation(s)
- Joshua F Baker
- Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia
| | - Brian C Sauer
- Salt Lake City VA Medical Center and University of Utah, Salt Lake City
| | - Grant W Cannon
- Salt Lake City VA Medical Center and University of Utah, Salt Lake City
| | - Chia-Chen Teng
- Salt Lake City VA Medical Center and University of Utah, Salt Lake City
| | - Kaleb Michaud
- University of Nebraska Medical Center, Omaha, and National Data Bank for Rheumatic Diseases, Wichita, Kansas
| | - Said Ibrahim
- Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and University of Pennsylvania, Philadelphia
| | - Erik Jorgenson
- Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia
| | - Lisa Davis
- Denver VA Medical Center, Denver, Colorado
| | | | - Amy Cannella
- University of Nebraska Medical Center, Omaha, VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska
| | - Ted R Mikuls
- University of Nebraska Medical Center, Omaha, VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska
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20
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Lana JP, Martins LB, Oliveira MCD, Menezes-Garcia Z, Yamada LTP, Vieira LQ, Teixeira MM, Ferreira AVM. TNF and IL-18 cytokines may regulate liver fat storage under homeostasis conditions. Appl Physiol Nutr Metab 2017; 41:1295-1302. [PMID: 27863204 DOI: 10.1139/apnm-2016-0265] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The inflammation induced by obesogenic diets is associated with deposition of fat in the liver. On the other hand, anti-inflammatory and immunosuppressive therapies may impact in body fat storage and in liver lipid dynamics. It is important to study specific inflammatory mediators in this context, since their role on hepatic damage is not fully clarified. This study aimed to evaluate the role of interleukin (IL)-18 and tumor necrosis factor (TNF) receptor in liver dysfunction induced by diet. Male C57BL/6 wild-type (WT), IL-18, and TNF receptor 1 knockout mice (IL-18-/- and TNFR1-/-) were divided according to the experimental diets: chow diet or a high-refined carbohydrate-containing diet. Alanine aminotransferase was quantified by colorimetric analysis. Total fat content in the liver was determined by Folch methods. Levels of TNF, IL-6, IL-4, and IL-13 in liver samples were measured by ELISA assay. IL-18 and TNFR knockout mice fed with chow diet showed higher liver triglycerides deposition than WT mice fed with the same diet (WT: 131.9 ± 24.5; IL-18-/-: 239.4 ± 38.12*; TNF-/-: 179.6 ± 50.45*; *P < 0.01). Furthermore, these animals also showed a worse liver histopathological score and lower levels of TNF, IL-6, IL-4, and IL-13 in the liver. Interestingly, treatment with a high-carbohydrate diet did not exacerbate liver damage in IL-18-/- and TNFR1-/- mice. Our data suggest that IL-18 and TNF may be involved on hepatic homeostasis mainly in a context of a healthy diet.
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Affiliation(s)
- Jaqueline Pereira Lana
- a Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,b Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Laís Bhering Martins
- a Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,b Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Chaves de Oliveira
- a Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,b Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Zélia Menezes-Garcia
- b Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Leda Quercia Vieira
- b Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mauro Martins Teixeira
- b Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adaliene Versiani Matos Ferreira
- a Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,b Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Albrecht K, Richter A, Callhoff J, Huscher D, Schett G, Strangfeld A, Zink A. Body mass index distribution in rheumatoid arthritis: a collaborative analysis from three large German rheumatoid arthritis databases. Arthritis Res Ther 2016; 18:149. [PMID: 27338263 PMCID: PMC4918111 DOI: 10.1186/s13075-016-1043-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/06/2016] [Indexed: 12/30/2022] Open
Abstract
Background METARTHROS (Metabolic impact on joint and bone disease) is a nationwide German network to investigate the overlap between inflammatory and metabolic diseases. The objective of this study was to compare the body mass index (BMI) distribution in patients with early and established rheumatoid arthritis (RA) with data from the general population, and to evaluate the association of BMI with patient characteristics and clinical markers. Methods The BMI distribution was examined with data collected at inclusion of patients in the early arthritis cohort CAPEA, the biologics register RABBIT, and the National database of the German Collaborative Arthritis Centers. A data source with a representative sample of the German population (German Ageing Survey) was used as a comparator. BMI categories of <18.5 kg/m2 (underweight), 18.5 to <25 kg/m2 (normal weight), 25 to <30 kg/m2 (overweight), and ≥30 kg/m2 (obese) were used. Patients were stratified by age and sex, and compared to controls from the German Ageing Survey. Associations between BMI and markers of disease activity were analysed with non-parametric tests and linear models. Results Data from 1207 (CAPEA), 12,230 (RABBIT), and 3424 (National database) RA patients and 6202 population controls were evaluated. The mean age was 56, 56, 62, and 62 years, respectively, the mean disease duration was 13 weeks, 9.9 years, and 13.5 years, respectively, and the mean disease activity score (DAS28) was 5.1, 5.2, and 3.1, respectively. In all RA cohorts, obesity was more frequent (23.8 %, 23.4 %, 21.4 %, respectively) than in controls (18.2 %). This applied to all age groups <70 years, was independent of disease duration, and was more pronounced in females. In all cohorts, the age at RA onset was associated with BMI, being higher in overweight/obese patients compared to normal-weight patients. Current smoking was negatively associated with BMI. Linear analyses revealed increased erythrocyte sedimentation rate (ESR) values in underweight and obese females, and an increasing disparity between tender joint counts (TJCs) and swollen joint counts (SJCs) in higher BMI categories. Conclusions Compared to the general population, a higher prevalence of obesity was observed in all RA cohorts. The dominance of obesity in females and the different behaviour of disease activity markers in relation to the BMI in females indicate that additional parameters need to be considered when analysing the impact of obesity on inflammation in RA. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1043-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katinka Albrecht
- German Rheumatism Research Centre, Epidemiology Unit, Charitéplatz 1, 10117, Berlin, Germany.
| | - Adrian Richter
- German Rheumatism Research Centre, Epidemiology Unit, Charitéplatz 1, 10117, Berlin, Germany
| | - Johanna Callhoff
- German Rheumatism Research Centre, Epidemiology Unit, Charitéplatz 1, 10117, Berlin, Germany
| | - Dörte Huscher
- German Rheumatism Research Centre, Epidemiology Unit, Charitéplatz 1, 10117, Berlin, Germany
| | - Georg Schett
- Department of Internal Medicine, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Anja Strangfeld
- German Rheumatism Research Centre, Epidemiology Unit, Charitéplatz 1, 10117, Berlin, Germany
| | - Angela Zink
- German Rheumatism Research Centre, Epidemiology Unit, Charitéplatz 1, 10117, Berlin, Germany.,Department of Rheumatology and Clinical Immunology, Charité University Hospital, Berlin, Germany
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Sfriso P, Caso F, Filardo GS, Botsios C, Costa L, Scarpa R, Todesco S, Spinella P, Oliviero F, Punzi L. Impact of 24 months of anti-TNF therapy versus methotrexate on body weight in patients with rheumatoid arthritis: a prospective observational study. Clin Rheumatol 2016; 35:1615-8. [PMID: 27048267 DOI: 10.1007/s10067-016-3244-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 02/05/2016] [Accepted: 03/22/2016] [Indexed: 01/06/2023]
Abstract
To evaluate the impact of anti-TNF-α therapy on the body weight of rheumatoid arthritis (RA) patients following 24 months of treatment. Data were collected on all RA patients included in the Veneto Region's Registry of Biological Therapy from January 2007 to July 2012. Inclusion criteria were: start of monotherapy with adalimumab, etanercept, or methotrexate, no previous use of biologic therapy, and at least 24 months of treatment. At baseline, 12, and 24 months, each patient completed a questionnaire about physical activity, smoking, alcohol, and food habits. One hundred and thirty-one RA patients in monotherapy with etanercept (n = 47), adalimumab (n = 44), and methotrexate (n = 40) were enrolled for this study. After 24 months of therapy, there was an increase of weight only in patients treated with anti-TNF-α. Patients on etanercept and adalimumab therapy showed a risk to gain weight six times greater compared to those on methotrexate therapy. The results of present study show that the use of anti-TNF-α in RA patients can be associated to a significant increase of body weight. This increase is not shown in patients under treatment with methotrexate. A more careful evaluation of weight changes needs to be considered in RA patients under anti-TNF-α treatment.
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Affiliation(s)
- Paolo Sfriso
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani, n.2, 35128, Padova, Italy.
| | - Francesco Caso
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani, n.2, 35128, Padova, Italy.,Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | - Giuseppe Sebastiano Filardo
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani, n.2, 35128, Padova, Italy
| | - Costantino Botsios
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani, n.2, 35128, Padova, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani, n.2, 35128, Padova, Italy.,Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | - Silvano Todesco
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani, n.2, 35128, Padova, Italy
| | - Paolo Spinella
- Clinical Nutrition Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Francesca Oliviero
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani, n.2, 35128, Padova, Italy
| | - Leonardo Punzi
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani, n.2, 35128, Padova, Italy
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Vidal C, Barnetche T, Morel J, Combe B, Daïen C. Association of Body Mass Index Categories with Disease Activity and Radiographic Joint Damage in Rheumatoid Arthritis: A Systematic Review and Metaanalysis. J Rheumatol 2015; 42:2261-9. [PMID: 26523023 DOI: 10.3899/jrheum.150224] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Obesity and overweight are increasing conditions. Adipose tissue with proinflammatory properties could be involved in rheumatoid arthritis (RA) activity and radiographic progression. This study aims to investigate the influence of overweight and obesity on RA activity and severity. METHODS We conducted a systematic review and metaanalysis to assess the association of body mass index (BMI) categories with the Disease Activity Score in 28 joints (DAS28), functional disability [Health Assessment Questionnaire (HAQ)], and radiographic joint damage in patients with RA. We searched Medline through PubMed, EMBASE, and the Cochrane Database of Systematic Reviews for all studies assessing DAS28, HAQ, or/and radiographic damage according to predefined BMI groups. RESULTS Among the 737 citations retrieved, 58 articles met the inclusion criteria and 7 were included in the metaanalysis. DAS28 was higher in obese (BMI > 30 kg/m(2)) than non-obese (BMI ≤ 30 kg/m(2)) patients (mean difference 0.14, 95% CI 0.01-0.27, p = 0.04, I(2) = 0%). HAQ score was also higher among obese patients (mean difference 0.10, 95% CI 0.01-0.19, p = 0.03, I(2) = 0%). Radiographic joint damage was negatively associated with obesity (standardized mean difference -0.15, 95% CI -0.29 to -0.02, p = 0.03, I(2) = 38%). CONCLUSION Obesity in RA is associated with increased DAS28 and HAQ score and with lower radiographic joint damage. These associations mainly result from an increase of subjective components of the DAS28 (total joint count and global health assessment) in obese patients. Conflicting results were reported concerning inflammation markers (C-reactive protein and erythrocyte sedimentation rate).
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Affiliation(s)
- Celine Vidal
- From the Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; Institut of Molecular Genetic of Montpellier, Unité Mixte de Recherche n. 5535 (UMR5535), Montpellier; Rheumatology Department, Hôpital Pellegrin, Bordeaux, France.C. Vidal, MD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; T. Barnetche, PhD, Rheumatology Department, Hôpital Pellegrin; J. Morel, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; B. Combe, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; C. Daïen, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535
| | - Thomas Barnetche
- From the Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; Institut of Molecular Genetic of Montpellier, Unité Mixte de Recherche n. 5535 (UMR5535), Montpellier; Rheumatology Department, Hôpital Pellegrin, Bordeaux, France.C. Vidal, MD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; T. Barnetche, PhD, Rheumatology Department, Hôpital Pellegrin; J. Morel, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; B. Combe, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; C. Daïen, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535
| | - Jacques Morel
- From the Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; Institut of Molecular Genetic of Montpellier, Unité Mixte de Recherche n. 5535 (UMR5535), Montpellier; Rheumatology Department, Hôpital Pellegrin, Bordeaux, France.C. Vidal, MD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; T. Barnetche, PhD, Rheumatology Department, Hôpital Pellegrin; J. Morel, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; B. Combe, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; C. Daïen, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535
| | - Bernard Combe
- From the Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; Institut of Molecular Genetic of Montpellier, Unité Mixte de Recherche n. 5535 (UMR5535), Montpellier; Rheumatology Department, Hôpital Pellegrin, Bordeaux, France.C. Vidal, MD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; T. Barnetche, PhD, Rheumatology Department, Hôpital Pellegrin; J. Morel, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; B. Combe, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; C. Daïen, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535
| | - Claire Daïen
- From the Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; Institut of Molecular Genetic of Montpellier, Unité Mixte de Recherche n. 5535 (UMR5535), Montpellier; Rheumatology Department, Hôpital Pellegrin, Bordeaux, France.C. Vidal, MD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; T. Barnetche, PhD, Rheumatology Department, Hôpital Pellegrin; J. Morel, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; B. Combe, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535; C. Daïen, MD, PhD, Rheumatology Department, Hôpital Lapeyronie, Montpellier I University, and Institut of Molecular Genetic of Montpellier, UMR5535.
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Peluso I, Palmery M. The relationship between body weight and inflammation: Lesson from anti-TNF-α antibody therapy. Hum Immunol 2015; 77:47-53. [PMID: 26472017 DOI: 10.1016/j.humimm.2015.10.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 10/08/2015] [Accepted: 10/11/2015] [Indexed: 01/23/2023]
Abstract
Obesity is associated with many pathological conditions. Tumor Necrosis Factor-α (TNF-α) is one of the key mediators of inflammation involved in the obesity-related insulin resistance development. We aim to review the human evidence useful to clarify the relationship between inflammation and body weight, with particular reference to TNF-α. Genetic polymorphisms and epigenetic factors, such as diet, could affect TNF-α activity. TNF-α is associated with obesity, but also with anorexia and cachexia. Despite the role of TNF-α in obesity-related diseases, anti-TNF-α antibody therapy is associated with an increase in adiposity. In conclusion the reviewed results suggest that inflammation is more likely a consequence rather than a cause of obesity.
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Affiliation(s)
- Ilaria Peluso
- Center of Nutrition, Council for Agricultural Research and Economics (CREA-NUT), Via Ardeatina 546, 00178 Rome, Italy
| | - Maura Palmery
- Department of Physiology and Pharmacology "V. Erspamer", "Sapienza" University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy.
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25
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Baker JF, Cannon GW, Ibrahim S, Haroldsen C, Caplan L, Mikuls TR. Predictors of longterm changes in body mass index in rheumatoid arthritis. J Rheumatol 2015; 42:920-7. [PMID: 25834210 DOI: 10.3899/jrheum.141363] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Low body mass index (BMI) is a risk factor for poor longterm outcomes in rheumatoid arthritis (RA). The purpose of this study was to identify factors associated with longterm changes in BMI. METHODS Subjects with RA from the Veterans Affairs (VA) Rheumatoid Arthritis (VARA) Registry (n = 1474) were studied. Information on inflammatory markers, presence of erosions, and smoking status were extracted from the VARA database. BMI was extracted from VA electronic medical records within 14 days of each visit date. VA pharmacy records were queried to identify prescriptions for specific RA therapies within 1 month of the visit date. We used robust generalized estimating equations marginal regression models to calculate independent associations between clinical variables and BMI over time. Similar models determined predictors of change in weight and risk of weight loss over the subsequent study observation period. RESULTS Increasing age, active smoking, and the presence of erosions at baseline were associated with lower BMI. Weight decreased over time among older adults. Factors associated with greater reductions in BMI over time and a greater risk of weight loss were higher inflammatory markers, smoking, older age, higher BMI, and less subsequent improvement in inflammation. Methotrexate use was associated with a lower risk of weight loss. The use of prednisone or anti-tumor necrosis factor therapies was not associated with change in BMI or the risk of weight loss independent of other factors. CONCLUSION Greater age, greater inflammatory activity, and active smoking are associated with greater weight loss in RA over time.
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Affiliation(s)
- Joshua F Baker
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center.
| | - Grant W Cannon
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
| | - Said Ibrahim
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
| | - Candace Haroldsen
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
| | - Liron Caplan
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
| | - Ted R Mikuls
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
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Interleukin 6 blockade-associated weight gain with abdominal enlargement in a patient with rheumatoid arthritis. J Clin Rheumatol 2013; 19:48-9. [PMID: 23319026 DOI: 10.1097/rhu.0b013e31827cdda7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Current World Literature. Curr Opin Rheumatol 2013; 25:398-409. [DOI: 10.1097/bor.0b013e3283604218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Krügel U, Fischer J, Radicke S, Sack U, Himmerich H. Antidepressant effects of TNF-α blockade in an animal model of depression. J Psychiatr Res 2013; 47:611-6. [PMID: 23394815 DOI: 10.1016/j.jpsychires.2013.01.007] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 11/26/2012] [Accepted: 01/11/2013] [Indexed: 12/31/2022]
Abstract
Pro-inflammatory cytokines such as tumour necrosis factor-alpha (TNF-α) have repeatedly been shown to play a pivotal role in the pathophysiology of depression. Therefore, we tested the possible antidepressant-like effect of the anti-TNF-α drug etanercept in an animal model of chronic mild stress. Male Wistar rats were assigned to a non-restrained and a restrained protocol for 5 weeks. From beginning of the third week the animals were treated either with Ringer solution daily or with etanercept twice a week (0.3 mg/kg, i.p.) instead of Ringer solution (n = 12 each). As reference, imipramine (10 mg/kg, i.p.) was administered in a third restraint group daily. Naïve non-treated non-restrained rats served as healthy controls (n = 12). In the forced swim test (FST) depression-like behaviour induced by restraint was recorded as enhanced immobile time and reduced climbing activity of the vehicle-treated group in comparison to the naïve and the non-restrained vehicle treated group. The treatment with etanercept significantly reduced the depression-like effects resulting in reduced immobile time in the FST and intensified climbing behaviour (p < 0.01, p < 0.05), both similar to the antidepressive-like effect of imipramine (p < 0.01 both). The repeated restraint induced a loss of body weight gain in the Ringer-treated group which was not reversed, neither by imipramine nor by etanercept. The antidepressant effects of blocking TNF-α using etanercept may be caused by enhancement of serotonergic or noradrenergic neurotransmission or normalization of stress hormone secretion which has to be substantiated in further studies.
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Affiliation(s)
- Ute Krügel
- Rudolf Boehm Institute of Pharmacology and Toxicology, Medical Faculty, University of Leipzig, Härtelstrasse 16-18, D-04107 Leipzig, Germany.
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Jurgens MS, Jacobs JWG, Geenen R, Bossema ER, Bakker MF, Bijlsma JWJ, van Albada-Kuipers IA, Ehrlich JC, Lafeber FPJG, Welsing PMJ. Increase of body mass index in a tight controlled methotrexate-based strategy with prednisone in early rheumatoid arthritis: Side effect of the prednisone or better control of disease activity? Arthritis Care Res (Hoboken) 2012; 65:88-93. [DOI: 10.1002/acr.21797] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 06/29/2012] [Indexed: 11/08/2022]
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Younis S, Rosner I, Rimar D, Boulman N, Rozenbaum M, Odeh M, Slobodin G. Weight change during pharmacological blockade of interleukin-6 or tumor necrosis factor-α in patients with inflammatory rheumatic disorders: a 16-week comparative study. Cytokine 2012; 61:353-5. [PMID: 23228348 DOI: 10.1016/j.cyto.2012.11.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Revised: 10/13/2012] [Accepted: 11/08/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Interleukin (IL)-6 -/- mice develop spontaneous mature onset obesity, while the influence of the pharmacological blockade of IL-6 on body weight in humans has not been previously reported. The aim of the present study was to observe weight change in patients treated with tocilizumab (TCZ). METHODS Twenty-one consecutive patients who started new treatment with TCZ were enrolled in the study. Sixteen consecutive patients who started treatment with infliximab (IFX) formed the control group. Height and weight of all patients were registered and Body Mass Index (BMI) calculated before the first treatment and at week 16. The Mann-Whitney or paired Wilcoxon test were used for comparisons between or within groups, respectively. RESULTS The study demonstrated that treatment with TCZ was accompanied with significant weight gain and BMI increase (p=0.04), while IFX treatment did not result in any significant weight change during the 16-week period. CONCLUSIONS Weight gain can be seen in some patients during the pharmacological blockade of IL-6. The phenomenon and metabolic pathways involved should be further investigated.
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Affiliation(s)
- Said Younis
- Rheumatology, Bnai Zion Medical Center, Haifa, Israel
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