Cachexia Prevalence in a Population of Moroccan Women with Rheumatoid Arthritis.

Abstract

Objective: To assess body composition in women with rheumatoid arthritis (RA) compared to healthy controls, to calculate the prevalence of rheumatoid Cachexia (RC), and to identify the associated factors.

Methods: We conducted a case-control study on 112 female patients with RA according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA; and 224 age-matched healthy women. Body composition (BC) and bone mineral density (BMD) scans were obtained using Dual-energy X-ray absorptiometry (DXA). RC was defined by a fat-free mass index (FFMI) below the 10^th percentile and a fat mass index (FMI) above the 25^th percentile compared with the control group. We conducted a comparison between RA patients and healthy controls then a multiple regression analysis was conducted where the dependant variable is the presence of RC.

Results: RC prevalence was 42.85% while the mean body mass index (BMI) was the same in both groups. RA patients had a higher FM and lower FFM comparing to healthy controls. In our population, 78.60% of patients were on methotrexate and 12.50% on anti TNF therapy. Comparison between patients with and without RC showed that patients with RC have a higher proportion of erosive arthritis and of active disease. Regression logistic analysis showed that RC was significantly associated to erosive arthritis and active disease (OR at 33.31 (8.42-131.70) and 8.98 (1.64-49.20) respectively), independently of age, erythrocyte sedimentation rate, C-reactive protein, disease duration, steroid cumulative dose and biologic Disease-Modifying Anti-Rheumatic Drugs(bDMARDs) use.

Conclusion: Our study showed that almost half of our RA patients have RC, even with a high BMI.