Rheumatoid cachexia (RC) is cachexia resulting from rheumatoid arthritis. It refers to the loss of mass and strength of the muscles. The word “Rheumatoid cachexia” was derived from a Greek word which meant “Bad condition”.
Rheumatoid arthritis is a chronic inflammatory arthritis and rheumatoid cachexia is one common complication of this. It occurs in about two third of the patients with rheumatoid arthritis. Although there is great improvement in the treatment available for rheumatoid arthritis, it is found that rheumatoid cachexia tends to persist even after the joint inflammation subsides. RC is also an important risk factor for cardiovascular diseases and increased mortality in rheumatoid arthritis.
Continue to read this article to learn all about rheumatoid cachexia – its causes, clinical features, and management.
What Are The Symptoms Of Rheumatoid Cachexia?
Rheumatoid cachexia basically means muscle wasting. Remember, even though there is muscle wasting, you will not lose weight. It is not the fat that reduces, but the lean muscles of your body.
Imagine when your muscles begin to waste? Yes, this means that your strength is going to reduce. You will not be able to carry out simple tasks like before. You will get tired easily. Therefore the dominating symptom of rheumatoid arthritis will be fatigability and inability to do simple tasks.
What Causes Rheumatoid Cachexia?
Although the exact cause of RC is not yet discovered, a few factors that contribute to the pathogenesis of RC have been found. These include cytokines, increased protein metabolism, reduced physical activity, and hormones.
Cytokines such as Tumour necrosis factor α (TNF-α) and Interleukins-1β (IL-1β) influences on the protein and energy metabolism.
Patients with rheumatoid arthritis also have a raised breakdown of proteins compared to normal healthy individuals. This increased protein metabolism is found to be associated with the productions of TNF-α.
Due to the joint pain and stiffness in patients with rheumatoid arthritis, their physical activity is significantly reduced. This often leads to loss of muscle. This is also known as disuse atrophy.
Hormones such as Growth hormone decline with age and play a role in age related muscle loss. However, the exact cause of muscle loss associated with aging is not clearly understood.
Do Medicines Play A Role In The Treatment Of Rheumatoid Cachexia?
Of course, they do. Medicines used for the treatment of rheumatoid arthritis are extremely important to prevent and control RC. Better the control of rheumatoid arthritis, lesser the muscle loss. However, it has been found that even with better treatment methods for rheumatoid arthritis, the rheumatoid cachexia tends to persist even after the joint inflammation has completely reduced.
THF-α has been found to play a role in the pathogenesis of rheumatoid cachexia, and therefore drugs that block TNF-α has been introduced to treat the cachexia. These drugs are known as anti-TNF-α drugs or TNF blockers. Examples of these drugs are Etanercept, Infliximab and adalimumab. These drugs have shown to improve the muscle mass in these patients.
Can Rheumatoid Cachexia Be Treated?
Unfortunately, there is no known cure for RC but there are so many things that you can do to strengthen your muscles and slow down the progression of muscle loss. Exercise and diet will help you achieve this.
Resistance training is recommended to patients with rheumatoid arthritis. These include exercises against a resistance (push or pull exercises) such as in water to strengthen your muscles. It has been proven that resistance training not only help to improve the muscle mass and increases the array of movement; it also reduces the joint pain and supports people to lose weight.
Majority of the patients with rheumatoid arthritis are malnourished and therefore should pay attention to the meals they take. In some patients with rheumatoid arthritis suffer with both RC and obesity. Certain studies have shown that the addition of fish oil to the diet helps patients to improve their weight and muscle strength and at the same time reducing the fatigability.
Speak with your doctor to get a detailed explanation regarding the diet plans. They will probably suggest a high protein diet.
Rheumatoid cachexia (RC) is a known complication of untreated rheumatoid arthritis. It basically refers to the loss of mass and strength of the muscles. Most patients with RC find it difficult to carry out simple tasks and get tired very easily. A number of contributing factors such as Tumor Necrosis Factor- α, increased protein metabolism, sedentary lifestyle and growth hormones have been found to play a role in the pathogenesis of rheumatoid cachexia. However, the exact cause is not known. Even though there is no exact cure for the disease, TNF-α blockers have shown to improve the muscle mass. Additionally, resistance training exercises and a healthy diet rich with proteins also helps to strengthen the muscles of these patients.