“The fact that [the REF] is stepping up to allow us to roll the body composition studies into an ongoing study in which the cohort is already assembled, and important outcome data is already being collected, is an efficient and less expensive way to study this important but poorly studied clinical problem in rheumatoid arthritis,” says Dr. Bathon.
Study Specifics
The REF award of $400,000 is funding research on body composition in RA patients for two years—from July 2007 to June 2009. These studies are incorporated into the third and final visit of the ESCAPE-RA study. Dr. Bathon says findings from her latest study may well be significant in the day-to-day treatment and management of RA patients. “The findings are particularly important because body composition is a modifiable risk factor,” she stresses. “Our ongoing studies will hopefully clarify the contribution of the adverse body composition phenotype to cardiovascular risk, disability, and joint damage, and will lay the groundwork for clinical recommendations and interventions to identify and reverse adverse body composition phenotypes, in order to reduce morbidity and mortality in RA.” The overall hypothesis is that RA patients have an adverse body composition profile, which is an independent contributor to poor health outcomes in RA.
The REF-funded study involves 196 participants with RA who previously enrolled in ESCAPE-RA. The cohort consists of 118 women and 78 men who have no prior self-reported, physician-diagnosed clinical cardiovascular event. The study includes three visits, with the following data collected at each visit:
- Cardiovascular history;
- RA history;
- Medical history;
- Medications;
- Physical activity;
- Diet;
- Psychosocial factors;
- Extra-articular disease; and
- Family history.
The physical exam consists of vital signs, anthropometry (weight, height, body mass index, and waist and hip circumference), and 48-joint assessment for tenderness, swelling, malalignment, and range of motion. At the first and third visits, cardiac CT scans for coronary artery calcium are obtained. Carotid ultrasound was funded in the ESCAPE study for the first visit and will be repeated at the third visit using the REF funds. Total body DXA scans as well as abdominal and mid-thigh CT scans likewise will be added at the third visit through the REF grant. Coronary artery calcium and carotid plaque and intima-media thickness will be used as surrogate measures of atherosclerotic plaque in study participants. Other measures include the short Physical Performance Battery to measure physical function and disability, radiographic assessment of joint damage, the disease activity score for 28 joints, C-reactive protein, self-reported habitual physical activity assessment using a seven-day questionnaire, and a composite score to assess cardiovascular risk.