Does an IM Depot corticosteriod injection cause muscle loss in RA?
Research type
Research Study
Full title
DOES A SINGLE HIGH DOSE INTRA-MUSCULAR CORTICOSTEROID INJECTION, GIVEN FOR TREATMENT OF DISEASE FLARE, EXACERBATE MUSCLE LOSS IN RA PATIENTS?
IRAS ID
169096
Contact name
Fazal Sheikh
Contact email
Sponsor organisation
Bangor University
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Rheumatoid arthritis (RA) is characterised by abnormal body composition including muscle loss which contributes to reduced strength and impaired physical function. Although successful in controlling disease activity, current drug treatments do not restore muscle mass. Corticosteroids (CS), which have been a cornerstone in the treatment of RA for the last half century, are routinely used in combination with other disease modifying anti rheumatic drugs (DMARDS) in the management of active RA during early disease and flares. Despite providing effective relief of inflammation, previous studies have shown that treatment with CS can have unfavorable effects on body composition. Additionally, our research group recently observed a substantial loss of muscle (˜ 2kg) in an RA patient following a single intramuscular (IM) CS injection.
The aim of the study is to investigate the effects on muscle mass, of a single high dose IM CS injection given to control a flare in RA patients. We hypothesize that acute loss of muscle mass (assessed by appendicular lean mass (ALM) by Dual-energy X-ray absorptiometry (DXA)) occurs as a result of high dose IM CS injection in RA patients.
Patients requiring high dose depot IM CS injection to control their flare will undergo a DXA scan (to estimate lean and fat masses) and routine anthropometric measures on the day of their steroid injection and 3-4 weeks later. The disease activity of each participant will also be assessed by the Disease Activity Score in 28 joints (DAS28-CRP), and systemic inflammation by C-reactive protein (CRP).
This pilot study is a quasi-experimental design (single group, pre-post intervention) therefore no control group will be used.
This study will provide insights into whether treatment of RA flares with high-dose IM CS has the negative consequence of exacerbating muscle loss and, thus, further reducing physical function in RA patients.REC name
Wales REC 5
REC reference
15/WA/0013
Date of REC Opinion
23 Jan 2015
REC opinion
Further Information Favourable Opinion