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© 2023 Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

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.

Details

Title
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
Author
Güler-Yüksel, Melek 1   VIAFID ORCID Logo  ; Kuijper, Martijn 1 ; Bos, Reinhard 2 ; Molenaar, Esmeralda 3 ; Emmering, Jasper 4 ; Eshuis, Sylvia 5 ; Adams, Human 6 ; Reimann, Floor 2 ; Boers, Maarten 7   VIAFID ORCID Logo  ; Kok, Marc R 1   VIAFID ORCID Logo 

 Department of Rheumatology and Immunology, Maasstad Hospital, Rotterdam, The Netherlands 
 Department of Rheumatology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands 
 Department of Rheumatology, Groene Hart Hospital, Gouda, The Netherlands 
 Department of Radiology and Nuclear Medicine, Maasstad Hospital, Rotterdam, The Netherlands 
 Department of Nuclear Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands 
 Department of Nuclear Medicine, Groene Hart Hospital, Gouda, The Netherlands 
 Department of Epidemiology & Data Science, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands 
First page
e002905
Section
Rheumatoid arthritis
Publication year
2023
Publication date
Jun 2023
Publisher
BMJ Publishing Group LTD
e-ISSN
20565933
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2828468213
Copyright
© 2023 Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.