Rheumatoid cachexia is an under-recognized condition characterized by loss of lean body tissue, which associates with poor clinical outcomes and may respond to resistance training and anti-TNF therapies.
Rheumatoid cachexia is a clinically significant but under-recognized feature of RA that may respond to progressive resistance training and anti-TNF therapies.
Rheumatoid cachexia is under-recognized in clinical practice. The loss of lean body tissue, which characterizes cachexia, is often compensated for by gain in body fat-so called 'cachectic obesity'-so that 85% or more RA patients have a normal BMI. Severe cachexia with loss of weight leads to increased morbidity and premature mortality but loss of muscle bulk with a normal BMI also associates with poor clinical outcomes. Increasing BMI, even into the obese range, is associated with less joint damage and reduced mortality. Measurement of body composition using DXA and other techniques is feasible but the results must be interpreted with care. Newer techniques such as whole-body MRI will help define with more confidence the mass and distribution of fat and muscle and help elucidate the relationships between body composition and outcomes. Cachexia shows little response to diet alone but progressive resistance training and anti-TNF therapies show promise in tackling this potentially disabling extra-articular feature of RA.
Summers et al. (Tue,) conducted a review in Rheumatoid cachexia. Rheumatoid cachexia is an under-recognized condition characterized by loss of lean body tissue, which associates with poor clinical outcomes and may respond to resistance training and anti-TNF therapies.