Skip to main content

Advertisement

Log in

Impact of 24 months of anti-TNF therapy versus methotrexate on body weight in patients with rheumatoid arthritis: a prospective observational study

Clinical Rheumatology Aims and scope Submit manuscript

ABSTRACT

To evaluate the impact of anti-TNF-α therapy on the body weight of rheumatoid arthritis (RA) patients following 24 months of treatment. Data were collected on all RA patients included in the Veneto Region’s Registry of Biological Therapy from January 2007 to July 2012. Inclusion criteria were: start of monotherapy with adalimumab, etanercept, or methotrexate, no previous use of biologic therapy, and at least 24 months of treatment. At baseline, 12, and 24 months, each patient completed a questionnaire about physical activity, smoking, alcohol, and food habits. One hundred and thirty-one RA patients in monotherapy with etanercept (n = 47), adalimumab (n = 44), and methotrexate (n = 40) were enrolled for this study. After 24 months of therapy, there was an increase of weight only in patients treated with anti-TNF-α. Patients on etanercept and adalimumab therapy showed a risk to gain weight six times greater compared to those on methotrexate therapy. The results of present study show that the use of anti-TNF-α in RA patients can be associated to a significant increase of body weight. This increase is not shown in patients under treatment with methotrexate. A more careful evaluation of weight changes needs to be considered in RA patients under anti-TNF-α treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Summers GD, Metsios GS, Stavropoulos-Kalinoglou A, Kitas GD (2010) Rheumatoid cachexia and cardiovascular disease. Nat Rev Rheumatol 6:445–451

    Article  PubMed  Google Scholar 

  2. Roubenoff R, Roubenoff RA, Cannon JG et al (1994) Rheumatoid cachexia: cytokine-driven hypermetabolism accompanying reduced body cell mass in chronic inflammation. J Clin Invest 93:2379–2386

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Reid MB, Li YP (2001) Tumor necrosis factor-alpha and muscle wasting: a cellular perspective. Respir Res 2:269–272

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Lang CH, Frost RA (2002) Role of growth hormone, insulin-like growth factor-I, and insulin-like growth factor binding proteins in the catabolic response to injury and infection. Curr Opin Clin Nutr Metab Care 5:271–279

    Article  CAS  PubMed  Google Scholar 

  5. Alcorn N, Tierney A, Wu O, Gilmour H, Madhok R (2010) Impact of anti-tumour necrosis factor therapy on the weight of patients with rheumatoid arthritis. Ann Rheum Dis 69:1571

    Article  PubMed  Google Scholar 

  6. Chen CY, Tsai CY, Lee PC, Lee SD (2013) Long-term etanercept therapy favors weight gain and ameliorates cachexia in rheumatoid arthritis patients: roles of gut hormones and leptin. Curr Pharm Des 19:1956–1964

    Article  CAS  PubMed  Google Scholar 

  7. Brown RA, Spina D, Butt S, Summers GD (2012) Long-term effects of anti-tumour necrosis factor therapy on weight in patients with rheumatoid arthritis. Clin Rheumatol 31:455–461

    Article  PubMed  Google Scholar 

  8. Inui A, Meguid MM (2003) Cachexia and obesity: two sides of one coin? Curr Opin Clin Nutr Metab Care 6:395–399

    CAS  PubMed  Google Scholar 

  9. Wellens RI, Roche AF, Khamis HJ, Jackson AS, Pollock ML, Siervogel RM (1996) Relationships between the body mass index and body composition. Obes Res 4:35–44

    Article  CAS  PubMed  Google Scholar 

  10. Fearon K, Strasser F, Anker SD et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495

    Article  PubMed  Google Scholar 

  11. Stavropoulos-Kalinoglou A, Metsios GS, Koutedakis Y et al (2007) Redefining overweight and obesity in rheumatoid arthritis patients. Ann Rheum Dis 66:1316–1321

    Article  PubMed  PubMed Central  Google Scholar 

  12. Scirè CA, Caporali R, Sarzi-Puttini P, Frediani B, Di Franco M, Tincani A, Sinigaglia L, Sfriso P, Tirri R, Bellis E, Delsante G, Porru G, Salaffi F, Giuggioli D, Rossini M, Todoerti M, Bazzichi L, Govoni M, Gerli R, Raschetti R, Minisola G, Montecucco C, Todesco S, Monitornet project (2013) Drug survival of the first course of anti-TNF agents in patients with rheumatoid arthritis and seronegative spondyloarthritis: analysis from the MonitorNet database. Clin Exp Rheumatol 31:857–863

    PubMed  Google Scholar 

  13. Sfriso P, Salaffi F, Montecucco CM, Bombardieri S, Todesco S (2009) MonitorNet: the Italian multi-centre observational study aimed at estimating the risk/benefit profile of biologic agents in real-world rheumatology practice. Reumatismo 61:132–139

    CAS  PubMed  Google Scholar 

  14. Questionario di valutazione degli stili di vita, ISS (Italian National Institute of Health) [http://www.iss.it/binary/ofad/cont/questionario%20giovani%20in%20forma.1225957648.pdf]

  15. Briot K, Garnero P, Le Henanff A, Dougados M, Roux C (2005) Body weight, body composition, and bone turnover changes in patients with spondyloarthropathy receiving anti-tumor necrosis factor alpha treatment. Ann Rheum Dis 64:1137–1140

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Franchimont D, Roland S, Gustot T, Quertinmont E, Toubouti Y, Gervy MC, Deviere J, Van Gossum A (2005) Impact of infliximab on serum leptin levels in patients with Crohn’s disease. J Clin Endocrinol Metab 90:3510–3516

    Article  CAS  PubMed  Google Scholar 

  17. Gisondi P, Cotena C, Tessari G, Girolomoni G (2008) Anti-tumor necrosis factor-alpha therapy increases body weight in patients with chronic plaque psoriasis: a retrospective cohort study. J Eur Acad Dermatol Venereol 22:341–344

    Article  CAS  PubMed  Google Scholar 

  18. Kirchgessner TG, Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS (1997) Tumor necrosis factor-alpha contributes to obesity-related hyperleptinemia by regulating leptin release from adipocytes. J Clin Invest 100:2777–2782

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Engvall IL, Elkan AC, Tengstrand B, Cederholm T, Brismar K, Hafstrom I (2008) Cachexia in rheumatoid arthritis is associated with inflammatory activity, physical disability, and low bioavailable insulin-like growth factor. Scand J Rheumatol 37:321–328

    Article  CAS  PubMed  Google Scholar 

  20. Pi-Sunyer FX (2002) The obesity epidemic: pathophysiology and consequences of obesity. Obes Res 10(Suppl 2):97S–104S

    Article  PubMed  Google Scholar 

  21. Nevill AM, Stewart AD, Olds T, Holder R (2004) Are adult physiques geometrically similar? The dangers of allometric scaling using body mass power laws. Am J Phys Anthropol 124:177–182

    Article  PubMed  Google Scholar 

  22. Cacciapaglia F, Navarini L, Menna P, Salvatorelli E, Minotti G, Afeltra A (2011) Cardiovascular safety of anti-TNF-alpha therapies: facts and unsettled issues. Autoimmun Rev 10:631–635

    Article  CAS  PubMed  Google Scholar 

  23. Dixon WG, Symmons DP (2007) What effects might anti-TNF alpha treatment be expected to have on cardiovascular morbidity and mortality in rheumatoid arthritis? A review of the role of TNF alpha in cardiovascular pathophysiology. Ann Rheum Dis 66:1132–1136

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Costa L, Caso F, Atteno M, Del Puente A, Darda MA, Caso P, Ortolan A, Fiocco U, Ramonda R, Punzi L, Scarpa R (2014) Impact of 24-month treatment with etanercept, adalimumab, or methotrexate on metabolic syndrome components in a cohort of 210 psoriatic arthritis patients. Clin Rheumatol 33:833–839

    PubMed  Google Scholar 

Download references

Acknowledgments

This study was in part supported by the Italian Medicines Agency (AIFA) within the independent drug research program, contract no. FARM5KJ9P5 and by Veneto Region (DGR3256 2007).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paolo Sfriso.

Ethics declarations

Disclosures

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sfriso, P., Caso, F., Filardo, G.S. et al. Impact of 24 months of anti-TNF therapy versus methotrexate on body weight in patients with rheumatoid arthritis: a prospective observational study. Clin Rheumatol 35, 1615–1618 (2016). https://doi.org/10.1007/s10067-016-3244-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-016-3244-7

Keywords

Navigation