Dynamics of body composition indicators in patients with early rheumatoid arthritis during therapy with methotrexate and biological drugs (pilot study)

Aim – to evaluate the parameters of body composition in patients with early rheumatoid arthritis on the background of anti-inflammatory therapy after 24 weeks of follow-up. Material and methods . The study included 37 patients (31 women and 6 men) with early RA (ACR/EULAR (American College of Rheumatology/European Alliance of Associations for Rheumatology) criteria 2010), who had their waist circumference (WC), height and weight measured, body mass index (BMI) calculated, body composition determined using dual-energy X-ray absorptiometry using the “Whole Body” program on the HOLOGIC device (USA) before prescribing and 6 months after antirheumatic therapy (methotrexate (MT) monotherapy, combination therapy: MT and a biologic agents). Results . Initially, patients with early RA who later required the appointment of combination therapy had higher values of anthropometric (weight, BMI, WC) and acute phase parameters (erythrocyte sedimentation rate, C-reactive protein). On the contrary, patients on MT monotherapy initially had a lower body weight, “skinny” and fat mass than patients receiving combination therapy. After 24 weeks of MT monotherapy, RA patients showed an increase in “lean” mass in the absence of changes in total fat mass; against the background of combination therapy, an increase in fat and total mass in the absence of changes in the mass of “skinny” tissue. In patients who achieved remission/low RA activity after 24 weeks of therapy, the initial BMI, adipose tissue mass and total body weight were lower than in patients with moderate/high disease activity persisting despite treatment. Conclusion . In patients with early RA, after 6 months of combination therapy (methotrexate and biological drugs), an increase in fat and total mass was observed in the absence of changes in the mass of lean tissue. On the contrary, in RA patients, against the background of MT monotherapy, an increase in lean mass was observed in the absence of changes in total fat mass. Insufficient effectiveness of anti-inflammatory therapy by the 3rd month of follow-up was associated with high baseline BMI, lean and fat mass, by the 6th month – with high BMI and fat mass.