What Is Rheumatoid Cachexia?

Rheumatoid cachexia refers to the multifactorial process of body mass and lean body mass loss in patients with rheumatoid arthritis (RA). It is characterised by a combination of inflammation-driven systemic factors, alterations in energy metabolism, reduced dietary intake, and changes in body composition. Cachexia in rheumatoid arthritis is a complex condition that can severely affect a person's quality of life and increase the risk of morbidity and mortality.

Key aspects of rheumatoid cachexia include:

- Inflammation: Chronic inflammation in RA leads to the release of pro-inflammatory cytokines and other mediators that can disrupt metabolic processes and contribute to muscle loss and weight loss.

- Altered metabolism: The inflammatory response alters the body's energy expenditure and substrate utilisation. Increased energy expenditure (hypermetabolism) and reduced energy intake can result in a negative energy balance and weight loss.

- Reduced dietary intake: Poor appetite, early satiety, and dysphagia (difficulty swallowing) are common symptoms in RA and can lead to inadequate nutritional intake. Pain, depression, and medications can further contribute to reduced food consumption.

- Changes in body composition: Rheumatoid cachexia is characterised by the loss of lean muscle mass, while fat mass may be preserved or even increased. This shift in body composition further impairs physical function, strength, and mobility.

Key points to remember:

- Rheumatoid cachexia is a multifactorial condition characterised by weight loss, muscle loss, and impaired functional status in individuals with rheumatoid arthritis.

- Chronic inflammation, altered metabolism, reduced food intake, and changes in body composition contribute to the development of rheumatoid cachexia.

- Early assessment of nutritional status and appropriate interventions, including nutritional support, exercise, and management of inflammation, are crucial in preventing or managing rheumatoid cachexia.