Cachexia in Systemic Lupus Erythematosus: Risk Factors and Relation to Disease Activity and Damage.

Abstract:

OBJECTIVE:Cachexia is a disorder characterized by involuntary weight loss in addition to loss of homeostatic control of both energy and protein balance. Despite an abundance of data from other inflammatory diseases, cachexia in SLE remains a largely undescribed syndrome. METHODS:2406 patients in a prospective SLE cohort had their weight assessed at each visit. Patients were categorized into five predetermined groups based on weight. Cachexia was defined based on modified Fearon criteria (5% stable weight loss in 6 months without starvation relative to the average weight in all prior visits AND/OR weight loss >2% without starvation relative to the average weight in all prior cohort visits and a BMI <20). Risk of cachexia within 5 years of cohort entry was based on Kaplan Meier estimates. The association of prior disease manifestations with risk of cachexia adjusted by current steroid use was determined using Cox regression. An analysis of variance test was used to determine whether SLICC/ACR Damage Index scores varied based on cachexia status. RESULTS:Within five years of cohort entry, 56% of patients developed cachexia, 18% of which never recovered their weight during follow up. The risk factors for cachexia development were BMI<20, current steroid use, vasculitis, lupus nephritis, serositis, hematologic, positive anti-dsDNA, anti-Sm, and anti-RNP. Patients with intermittent cachexia had significantly higher SLICC/ACR Damage Index compared to those with continuous cachexia or without cachexia. CONCLUSION:Cachexia is an underrecognized syndrome in patients with SLE. SLE patients with intermittent cachexia have the highest risk of future organ damage.

authors

Stojan G,Li J,Wittmaack A,Petri M

doi

10.1002/acr.24395

subject

Has Abstract

pub_date

2020-08-02 00:00:00

eissn

2151-464X

issn

2151-4658

pub_type

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