View conference programme - The British Society for Rheumatology

• Recent advances in spondyloarthritis imaging – is enthesitis the key?
Dennis McGonagle
Enthesitis on closely associated osteitis present at all sites of disease in the
spondyloarthropathies are present in both axial and peripheral sites of disease in
the spondyloarthropathy. This talk will be to review the imaging findings of
enthesitis and the advantages and disadvantages of sonography in the assessment
of enthesial related pathologies and will show how imaging has transformed the
understanding of these diseases.
• Anti-TNF therapy for ankylosing spondylitis Jürgen Braun
10:30 – 12:30 BSR: Muscle: the neglected organ in arthritis Fintry
Chair: Andrew Lemmey
• The concept of rheumatoid cachexia Laura Rall
Patients with rheumatoid arthritis (RA) experience a loss of metabolically active
tissue that we have termed ‘rheumatoid cachexia’. This loss of lean body mass is
an important contributor to morbidity and mortality in RA. Many factors appear to
contribute to rheumatoid cachexia, including catabolic cytokines, inadequate
dietary intake, steroid effects, and decreased physical activity.
• The consequences of sarcopenia – lessons from ageing Marco Narici
Sarcopenia is regarded as a major cause of muscle weakness in ageing. Several
factors are known to contribute to the development of sarcopenia and the
associated impact on function. Loss of skeletal muscle fibres secondary to
decreased numbers of motoneurons appears to be a major contributing influence,
but other factors, including decreased physical activity, altered hormonal status,
decreased total caloric and protein intake, inflammatory mediators, and changes in
protein synthesis, are also involved. However, in ageing, the loss of muscle strength
typically exceeds that of muscle size and this leads to a decrease in force-per unit
area (muscle-quality). Although, this phenomenon is partly explained by a decrease
in the force per unit area of muscle fibres (specific tension) and by a reduction in
voluntary neural drive to the muscle, recent evidence suggests that changes in
muscle architecture and in tendon mechanical properties may significantly
contribute to this phenomenon. The present paper will present new findings in
this field and will illustrate the role of myotendinous alterations, associated with
sarcopenia, in the loss of muscle function in old age.
• The role of exercise and other anabolic interventions Samuele Marcora
Studies on the effects of resistance exercise, anabolic steroids, dietary amino acids
supplementation and anti-TNF therapy on muscle wasting and physical function in
rheumatoid arthritis patients will be presented and discussed.
• Exercise in management of RA - safe, effective and efficient. Impossible?
Oh ye of little faith Mike Hurley
In order to convince the doubters, the safety and efficacy of exercise in improving
pain and disability in RA is briefly reviewed. In order to confront the doubters, the
difficulties of implementing clinical practicable exercise regimens, and how these
might be addressed, are discussed. In order to blame the doubters, the vital role
healthcare professionals play in helping patients help themselves is emphasised.
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