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Volume 33, Issue 3, September 2022



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Mediterr J Rheumatol 2022;33(3):271-90
Time to Deal with Rheumatoid Cachexia: Prevalence, Diagnostic Criteria, Treatment Effects and Evidence for Management
Authors Information

1Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Sindos, Thessaloniki, Greece

2Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University General Hospital of Larissa, School of Health Sciences, University of Thessaly, Larissa, Greece

3Department of Dermatology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece

4Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynaecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece

MG Grammatikopoulou, K Gkiouras, G Efthymiou, E Zafiriou, DG Goulis, LI Sakkas, DP Bogdanos

Abstract

Cachexia is an early result of rheumatoid arthritis (RA) (rheumatoid cachexia, RC), characterised mainly by involuntary loss of fat-free mass. RC is apparent in 1-67% of patients with RA, depending on the diagnostic criteria applied and the method used for the assessment of body composition. RC is associated with increased inflammation and disability, lower health perception, and greater mortality risk. These changes in body composition are driven by the inflammation process, the low levels of physical activity, the underlying testosterone deficiency and hypogonadism, and the pharmacotherapy required for RA. Chronic inflammation enhances resting energy expenditure as a response to stress, inducing an energy deficit, further propelling protein turnover. The use of corticosteroids and tumour necrosis factor α (TNF-α) inhibitors tend to increase fat accumulation, whereas other disease-modifying antirheumatic drugs (DMARDs) appear to induce increments in fat-free mass. The present review presents all information regarding the prevalence of RC, diagnostic criteria, and comorbidities, as well as the effects of pharmacotherapy and medical nutrition therapy on body composition of patients with RA.


Cite this article as: Efthymiou E, Grammatikopoulou MG, Gkiouras K, Efthymiou G, Zafiriou E, Goulis DG, Sakkas LI, Bogdanos DP. Time to Deal with Rheumatoid Cachexia: Prevalence, Diagnostic Criteria, Treatment Effects and Evidence for Management. Mediterr J Rheumatol 2022;33(3):271-90.

Article Submitted: 13 Jan 2022; Revised Form: 25 Jun 2022; Article Accepted: 15 Jul 2022; Available Online: 30 Sep 2022

https://doi.org/10.31138/mjr.33.3.271

This work is licensed under a Creative Commons Attribution 4.0 International License.

©Efthymiou E, Grammatikopoulou MG, Gkiouras K, Efthymiou G, Zafiriou E, Goulis DG, Sakkas LI, Bogdanos DP.