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The role of tumour necrosis factor α (TNFα) in cachexia is established.1 More recent studies have found that adipocytes of obese animals and humans express higher levels of TNF than controls2 3; in this phenotype higher concentrations of TNFα are thought to limit further fat accumulation.4 5 We observed weight gain was becoming an increasing problem in some of our patients with rheumatoid arthritis (RA) given anti-TNF therapy. Several patients had raised this concern at review appointments and one even elected to discontinue anti-TNF treatment owing to weight gain. The authors therefore undertook a longitudinal retrospective review of …
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