TY - JOUR
T1 - Changes in body weight and body composition in patients with active rheumatoid arthritis aged 65+ treated with 2-year low-dose add-on prednisolone in the randomised double-blind placebo-controlled GLORIA trial
AU - Güler-Yüksel, Melek
AU - Kuijper, Martijn
AU - Bos, Reinhard
AU - Molenaar, Esmeralda
AU - Emmering, Jasper
AU - Eshuis, Sylvia
AU - Human, Adams
AU - Reimann, Floor
AU - Boers, Maarten
AU - Kok, Marc R.
N1 - Funding Information: The GLORIA study is part of a larger project funded by the European Union’s Horizon 2020 research and innovation program under grant agreement No. 634886. The funder had no role in the design, collection, analysis or interpretation of the data, the writing of the report or the decision to publish. Funding Information: The GLORIA study is part of a larger project funded by the European Union's Horizon 2020 research and innovation program under grant agreement No. 634886. The funder had no role in the design, collection, analysis or interpretation of the data, the writing of the report or the decision to publish. Publisher Copyright: © 2023 Author(s) (or their employer(s)).
PY - 2023/6/22
Y1 - 2023/6/22
N2 - OBJECTIVES: To investigate the effect of 2 years of add-on prednisolone 5 mg/day on body weight and composition in patients with active rheumatoid arthritis (RA) aged 65+ and the relation with disease activity. METHODS: The Glucocorticoid Low-dose Outcome in RheumatoId Arthritis trial, a pragmatic, placebo-controlled, double-blind, randomised controlled trial investigated the balance of benefit and harm of 2 years of prednisolone 5 mg/day added to standard care in 451 patients with active RA aged 65+. In the current study, 449 patients were included, and body weight and Disease Activity Score of 28 Joints were measured at baseline and after 3, 6, 12, 18 and 24 months. In 57 patients, body composition was assessed at baseline and after 2 years with dual-energy X-ray absorptiometry. Data were analysed with longitudinal mixed models. RESULTS: The mean (95% CI) change in body weight was 0.9 (0.3 to 1.6) kg in the prednisolone group and -0.4 (-1.1 to 0.2) kg in the placebo group (difference 1.3 (0.5-2.2), (p<0.01)). The treatment effect was independent of disease activity suppression and comprised mostly increase in (appendicular) lean mass after 2 years. There was no significant increase in total fat mass, nor redistribution of fat mass from peripheral to central tissues. CONCLUSIONS: Patients with active RA aged 65+ treated with prednisolone 5 mg/day for 2 years gained about 1 kg in weight, compared with minimal-non-significant-weight loss on placebo. Our data suggest that the small increase in weight is mostly lean mass, rather than increase or redistribution of fat mass traditionally associated with glucocorticoid treatment.
AB - OBJECTIVES: To investigate the effect of 2 years of add-on prednisolone 5 mg/day on body weight and composition in patients with active rheumatoid arthritis (RA) aged 65+ and the relation with disease activity. METHODS: The Glucocorticoid Low-dose Outcome in RheumatoId Arthritis trial, a pragmatic, placebo-controlled, double-blind, randomised controlled trial investigated the balance of benefit and harm of 2 years of prednisolone 5 mg/day added to standard care in 451 patients with active RA aged 65+. In the current study, 449 patients were included, and body weight and Disease Activity Score of 28 Joints were measured at baseline and after 3, 6, 12, 18 and 24 months. In 57 patients, body composition was assessed at baseline and after 2 years with dual-energy X-ray absorptiometry. Data were analysed with longitudinal mixed models. RESULTS: The mean (95% CI) change in body weight was 0.9 (0.3 to 1.6) kg in the prednisolone group and -0.4 (-1.1 to 0.2) kg in the placebo group (difference 1.3 (0.5-2.2), (p<0.01)). The treatment effect was independent of disease activity suppression and comprised mostly increase in (appendicular) lean mass after 2 years. There was no significant increase in total fat mass, nor redistribution of fat mass from peripheral to central tissues. CONCLUSIONS: Patients with active RA aged 65+ treated with prednisolone 5 mg/day for 2 years gained about 1 kg in weight, compared with minimal-non-significant-weight loss on placebo. Our data suggest that the small increase in weight is mostly lean mass, rather than increase or redistribution of fat mass traditionally associated with glucocorticoid treatment.
KW - Arthritis, Rheumatoid
KW - Glucocorticoids
KW - Inflammation
UR - http://www.scopus.com/inward/record.url?scp=85162761606&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/rmdopen-2022-002905
DO - https://doi.org/10.1136/rmdopen-2022-002905
M3 - Article
C2 - 37349120
SN - 2056-5933
VL - 9
JO - RMD OPEN
JF - RMD OPEN
IS - 2
M1 - e002905
ER -