| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH COMMUNICATION |
1 From the School of Sport, Health, and Exercise Sciences, University of Wales, Bangor, United Kingdom (SMM, KRC, ABL, and PJM), and the Rheumatology Department, Gwynedd Hospital, Bangor, United Kingdom (GM and PJM)
Background: Tumor necrosis factor (TNF) is an important mediator of cachexia, and its blockade prevents catabolism in animal models. However, little evidence shows that anti-TNF therapy is effective in treating cachexia in humans.
Objective: The main aim of this study was to investigate the effect of etanercept, a synthetic soluble TNF receptor, on body composition in patients with early rheumatoid arthritis (RA).
Design: Twenty-six patients were randomly assigned to 24 wk of treatment with etanercept or methotrexate; the latter is the first-line therapy for RA. Body composition, physical function, disease activity, systemic inflammation, and the circulating insulin-like growth factor (IGF) system were measured at baseline (week 0) and at follow-up (weeks 12 and 24). Twelve patients in each treatment group (9 F, 3 M) completed the study.
Results: Overall, no important changes in body composition were observed, despite a transient increase in IGF-I at week 12 (P < 0.01). However, the secondary analysis of those patients (6/treatment group) who gained weight during follow-up showed a significant effect of etanercept on the composition of the weight gained: 44% of weight gained in the etanercept group was fat-free mass, as compared with only 14% in the methotrexate group (P = 0.04). Etanercept and methotrexate were equally effective in controlling the disease and improving physical function.
Conclusions: Anti-TNF therapy with etanercept is not superior to that with methotrexate for the treatment of rheumatoid cachexia over a period of 6 mo. However, TNF blockade seems to normalize the anabolic response to overfeeding and, if these findings are confirmed, may be useful in conditions characterized by anorexia and weight loss.
Key Words: Cachexia • tumor necrosis factor • rheumatoid arthritis • body composition • weight gain
This article has been cited by other articles:
|
|
 |
|
  R. D. Winfield, M. J. Delano, K. Pande, P. O. Scumpia, D. LaFace, and L. L. Moldawer Myeloid-Derived Suppressor Cells in Cancer Cachexia Syndrome: A New Explanation for an Old Problem JPEN J Parenter Enteral Nutr, November 1, 2008; 32(6): 651 - 655. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Wang, C. Zhao, R. Moya, and J. D. Davies A Novel Role for CD4+ T Cells in the Control of Cachexia J. Immunol., October 1, 2008; 181(7): 4676 - 4684. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. D. Summers, C. M. Deighton, M. J. Rennie, and A. H. Booth Rheumatoid cachexia: a clinical perspective Rheumatology, August 1, 2008; 47(8): 1124 - 1131. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. S. Metsios, A. Stavropoulos-Kalinoglou, K. M. J. Douglas, Y. Koutedakis, A. M. Nevill, V. F. Panoulas, M. Kita, and G. D. Kitas Blockade of tumour necrosis factor-{alpha} in rheumatoid arthritis: effects on components of rheumatoid cachexia Rheumatology, December 1, 2007; 46(12): 1824 - 1827. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Popa, F. H J van den Hoogen, T. R D J Radstake, M. G Netea, A. E Eijsbouts, M. d. Heijer, J. W M van der Meer, P. L C M van Riel, A. F H Stalenhoef, and P. Barrera Modulation of lipoprotein plasma concentrations during long-term anti-TNF therapy in patients with active rheumatoid arthritis Ann Rheum Dis, November 1, 2007; 66(11): 1503 - 1507. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
