Infliximab reverses inflammatory muscle wasting (sarcopenia) in Crohn's disease. Issue 5 (8th January 2015)

• Record Type: Journal Article
• Authors: Subramaniam, K.; Fallon, K.; Ruut, T.; Lane, D.; McKay, R.; Shadbolt, B.; Ang, S.; Cook, M.; Platten, J.; Pavli, P.; Taupin, D.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 41:Issue 5(2015)
• Page Start: 419
• Page End: 428
• Publication Date: 2015-01-08
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.13058
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt13058-abs-0001"> <title>Summary</title> <sec id="apt13058-sec-0001" sec-type="section"> <title>Background</title> <p>Muscle wasting or sarcopenia arising from chronic inflammation is found in 60% of patients with Crohn's disease. Transcriptional protein NF‐κB reduces muscle formation through MyoD transcription and increases muscle breakdown by proteolysis.</p> </sec> <sec id="apt13058-sec-0002" sec-type="section"> <title>Aim</title> <p>As TNF is a potent activator of NF‐κB, and anti‐TNF agent infliximab (IFX) prevents NF‐κB activation, to determine whether or not Crohn's patients treated with IFX gain muscle volume and strength.</p> </sec> <sec id="apt13058-sec-0003" sec-type="section"> <title>Methods</title> <p>We performed a prospective, repeated‐measures cohort study in adult Crohn's disease patients with an acute disease flare. Patients were instructed not to vary diet or activity. Concomitant medications were kept stable. At week 1 (pre‐treatment), week 16 (post‐IFX induction) and week 25 (post‐first IFX maintenance dose), we assessed (i) MRI volume of quadriceps femoris at anatomical mid‐thigh; (ii) maximal concentric quadriceps contractions strength at three specific speeds of contraction; (iii) physical activity by validated instrument (IPAQ); (iv) Three‐day food record of intake and composition (food‐weighing method); (v) Serum levels of IL6.</p> </sec> <sec id="apt13058-sec-0004" sec-type="section"> <title>Results</title> <p>Nineteen patients (58% female; mean age 33.2 ± 10.7 years) were recruited. IFX increased muscle volume in both legs from baseline (right, 1505 cm<sup>3</sup>) to week 25 (right, 1569 cm<sup>3</sup>; <italic>P</italic> = 0.010). IFX also increased muscle strength in both legs from baseline (right 30°/s, 184.8 Nm) to week 25 (right 30°/s, 213.6 Nm; <italic>P</italic> = 0.002). Muscle volume gain correlated with male gender (<italic>P</italic> = 0.003). Significant gains in muscle volume and strength were unrelated to prednisolone use. Serum IL6 levels decreased by week 25 (<italic>P</italic> = 0.037).</p> </sec> <sec id="apt13058-sec-0005" sec-type="section"> <title>Conclusion</title> <p>The anti‐TNF agent infliximab reverses inflammatory sarcopenia in patients with Crohn's disease.</p> </sec> </abstract>