Rapid weight loss in RA patients should be viewed as an important and profound marker of an increased risk of death, researchers say.

In a study of 1,674 RA patients the researchers from the University of Pennsylvania in the US found a loss of ≥ 1kg/m² between clinic visits was associated with an important increase in the risk of death (HR 1.99).

Those who lost more than 3kg/m² had the greatest risk (HR 2.49), the study authors reported in Arthritis & Rheumatology. 

But patients who lost weight at a rate of less than 2kg/m² per year did not have an increased risk of death.

Their findings do not support a biologically protective role of obesity in RA but instead support  “the common dogma that rapid weight loss is a poor prognostic sign, while slower changes should be less alarming,” they wrote.

“Low body weight is not likely to be in the causal pathway to increased mortality in RA, it should be recognized as a profound and important marker of an increased risk of death by identifying those who have experienced significant weight loss.”

These patients should be monitored closely, they advised.