PANLAR 2021 Coverage

Sarcopenia, a Rheumatologic Challenge

By : Richard Aguirre
Periodista científico de Global Rheumatology by PANLAR.

12 August, 2021

"Xavier describes why this pathology should be seen as a priority in the management of patients, with the intention of improving their quality of life."

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Ricardo Xavier is a physician, rheumatologist from the University of Porto Alegre, specialist in Rheumatology, professor at the Federal University of Rio Grande do Sul, works at the Hospital de Clínicas in Porto Alegre, and currently holds the Presidency of the Brazilian Society of Rheumatology.

Dedicated to working with rheumatologic diseases in general, but with interest in diffuse connective tissue diseases. For this reason, he is interested in the management of sarcopenia, according to him one of the current challenges of rheumatology worldwide, since at the moment there are no drugs to provide an effective treatment.

At the hospital, he says, they were able to equip a basic research laboratory with which they are investigating some molecules with therapeutic potential in animal models of rheumatoid arthritis and systemic lupus erythematosus; in fact, they have some patents that are being evaluated.

In the case of sarcopenia, Xavier says that they have noticed that in the care of arthritis patients there are medications that are effective, such as anti-inflammatory drugs; however, in terms of physical function, such as walking speed, patients do not improve as much.

"We started to evaluate how the muscle function of these patients is," says Xavier, explaining that there are studies that show that due to the inflammatory process of arthritis, there was a loss of muscle mass in these patients. "With the therapies we have today, it was not observed that this muscle mass recovers with the treatment."

Therefore, when asked about the challenges facing rheumatology today, the professional does not hesitate to mention two. The first is the control of inflammatory processes, since many patients persist with chronic pain, and the second is sarcopenia, which, although there are patients who improve in their inflammatory processes, they continue with low muscle mass and disability associated with this low muscle mass.

In this regard, he emphasizes that in animal models they observed that the mechanisms of muscle mass loss occur within the muscle fiber in the process of protein degradation, but that it behaves differently for the animal that remains immobilized, compared to the animal with experimental arthritis. "So, arthritis causes an active mechanism of muscle fiber degradation," Xavier emphasizes .

Why sarcopenia? For him, it has not been a frequent concern in clinical practice and that is why they want to emphasize more the importance for patients; it is not only to control pain, but to go beyond that and recover their physical mobility functions.

"Some time ago, rheumatologists understood that bone mass is important, and medication is used because of the immobility of arthritis itself, since patients lose bone mass and the result can be a fracture, but we have not been very concerned about the muscle, which makes the bone move," the professional emphasizes.

In that sense, he comments, an important aspect is to begin to highlight the relevance that sarcopenia has on the quality of life of patients, understanding that for bone and osteoporosis there are drugs that are effective, but for sarcopenia there are none.

Along the same lines, he emphasizes that there are advanced research processes, so he is confident that "in a short time we will have new drugs that can contribute to the management of sarcopenia" and, of course, improve the quality of life of patients, which is ultimately what his work seeks to achieve.



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