We've heard the drug Infliximab mentioned a few times in our class readings (IBD, arthritis, nuero-degenerative disease...) It is an anti-TNFa drug often used to combat inflammatory diseases. The following article discusses effects of Infliximab on body composition and BMD.
http://7thspace.com/headlines/361040/infliximab_therapy_increases_body_fat_mass_in_early_rheumatoid_arthritis_independently_of_changes_in_disease_activity_and_levels_of_leptin_and_adiponectin_a_randomized_study_over_21_months.html
The conclusions from the study find that overall body fat mass increases while patients are taking the drug. Muscle and bone loss was prevented as well. The interesting part is that the fat mass increase is not associated with an increase in atherogenic lipids. In fact, there was an increase in adiponectin that the researchers suggest is a possible reason for the protective effects for heart disease in patients on Infliximab.
On a side note, there are no citations for this article. After a google search for these terms, there were no results outside of this article.
I find it both good and bad that the drug's side effects work in such a fashion. The bad part is obviously that it gains weight, but the good is that muscle mass and bone mass is not compromised! It would be interesting to analyze the test subjects behind this study because usually those who gain weight lose the initiative to participate in so much physical activity. Perhaps the drug could be influencing some sort of lipogenesis which doesn't inhibit energy levels. Food for thought!
ReplyDeleteI don't know whether to believe this article or not since there are no citations. But from the descriptions of this article Infliximab sounds like a drug that could benefit people more than it could harm them. Increasing overall body fat mass is a downside, but this downside can cause the body to increase the secretion of adiponectin.
ReplyDeleteIt is pretty easy to see these advantages from a physiological perspective. To a group of people who study the body and its processes, these claims seem to have more pros than cons. However, it also seems a little counter intuitive. Increase in fat mass would increase adiponectin but larger fat cells eventually release proinflammatory adipocytokines such as resistin, plasminogen activator inhibitor-1, and interleukin-6. It seems that if this drug is truly effective, the weight-gaining side affect would have to be monitored.
ReplyDeleteThis is an interesting observation that needs to be studied more carefully before firm conclusions can be drawn. I was able to locate the full text of this study at our medical library. There are references in that version, and more detail on the study design and results. The study was randomized, but not blinded, meaning that the investigators knew which treatment the patient received. The measurement of arthritis disease activity is somewhat subjective, and could have been biased by knowledge of treatment assignment. The groups were not very well matched at baseline. The infliximab group had a mean BMI=24.7; the control group had a mean BMI=27.7. The study was small-only 40 subjects, and the authors do not report a P value for this difference, but a quick calculation gives P=0.08-not quite statistically significant, but a definite trend. The authors report similar efficacy for the two treatment arms-this is in contrast to most studies, which show a clear superiority for infliximab.
ReplyDeleteThe greater weight gain in the infliximab group may have been due to a better response to therapy. With resumption of health, the subjects regained the weight they had lost due to the chronic inflammatory state of RA.