Cachexia is Underrecognized in Patients With SLE

A prospective study of 2406 patients revealed that cachexia is underrecognized in patients with systemic lupus erythematosus (SLE), despite the fact that more than half the participants in this study developed cachexia within 5 years.

The research team also noted that patients with SLE who had intermittent cachexia were at the highest risk of developing organ damage.

Cachexia is defined as involuntary loss of weight and muscle mass that may not be entirely reversed by supplementary nutrition, usually as a result of an underlying disease process. Although cachexia is common in patients with cancer, AIDS, congestive heart failure, and chronic obstructive pulmonary disease, it is also recognized in patients with inflammatory diseases.
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The researchers created 5 groups of participants with SLE, whose weight was measured at each visit. They defined cachexia as stable weight loss of 5% over 6 months, without starvation, compared with average weight in all prior visits; or as weight loss of more than 2% without starvation and a body mass index (BMI) of less than 20 kg/m².

Over 5 years, 56% of the participants developed cachexia; 18% of these participants never fully recovered their weight during the follow-up period. The researchers identified several risk factors for the development of cachexia in participants with SLE, including a BMI of less than 20 kg/m²; current steroid use; and certain comorbidities such as vasculitis, lupus nephritis, and serositis.

Participants who experienced intermittent cachexia had significantly higher scores on the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index than those who had either continuous cachexia or who did not develop cachexia.

“Despite an abundance of data from other inflammatory diseases, cachexia in SLE remains a largely undescribed syndrome,” the researchers concluded.

—Rebecca Mashaw

Reference:

Stojan G, Li J, Wittmaack A, Petri M. Cachexia in systemic lupus erythematosus: risk factors and relation to disease activity and damage. Arthritis Care Res. Published online August 2, 2020. https://doi.org/10.1002/acr.24395