To the Editor:
We read with great interest the recent contribution by Hmamouchi, et al1. They reported an early and significant increase in abdominal adiposity in patients with spondyloarthritis (SpA; mainly male subjects) while receiving anti-tumor necrosis factor (TNF)-α treatment. The patients were evaluated in a 2-year prospective study for body composition using dual-energy X-ray absorptiometry (DEXA; Hologic QDR 2000), and specific DEXA software was used to distinguish subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). The results showed an increase in both SAT (+31.9 cm2 or +24.2%) and VAT (+29.1 cm2 or +32.4%) at 2 years in this population, raising the question of the relationship between these changes in adipose tissue and cardiovascular (CV) risk.
This is not the first study to examine the issue of adipose tissue modifications during anti-TNF therapy. We previously evaluated the longterm consequences of anti-TNF treatment on body composition and fat distribution, together with changes in serum …
Address correspondence to Prof. É. Toussirot, University Hospital of Besançon, Clinical Investigation Center for Biotherapy INSERM CIC-1431, Place St. Jacques, 25000 Besançon, France. E-mail: etoussirot{at}chu-besancon.fr