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Background:Sarcopenia is characterized by progressive loss of muscle mass, strength, and physical function, and often accompanies other diseases such as osteoarthritis (OA)1. Both conditions are also significantly associated with poor quality of life (QoL).Objectives:A randomized controlled study was conducted to evaluate the effectiveness of creatinine, glutamine and β-hydroxy-β-methylbutyrate (HMB) supplementation in enhancing muscle mass and strength, physical function and QoL in adults with sarcopenia and knee OA.Methods:Sixty-two patients aged 40 years and above with sarcopenia diagnosed according to the European Working Group on Sarcopenia and with knee OA according to the criteria of American College of Rheumatology were included in the study DIMMUS. The participants were randomly assigned into two groups of intervention (n=31) and control (n=31). The intervention group received oral nutritional supplementation daily plus standardized exercise programme for 12 weeks and the control group received only rescue analgesic medication and exercise training. Muscle mass (appendicular skeletal muscle mass index [ASMMI] estimated by the Baumgartner et al.’s equation), muscle strength (handgrip strength), physical function (4-m gait speed) and QoL (SARQoL) were measured before and after the 12-week intervention. Safety was also recorded by assessments of adverse events.Results:There was no significant difference in baseline characteristics between the two groups (85.5% women, 63.5 ± 9.6 years, body mass index of 26.8 ± 4.5 kg/m2, 83.9% Kellgren-Lawerence grade II OA and 91.9% mild sarcopenia). A statistically significant improvement in the mean change of ASMMI (3.7 ± 1.0 kg/m2to 3.96 ± 1.1 kg/m2;P=0.0074), handgrip strength (18.8 ± 8.7 kg to 20.5 ± 8.5 kg,P=0.0089), and SARQoL score (59.3 ± 8.8 vs 70.7 ± 16.6;P=0,0003) from baseline to 12 weeks was observed for the intervention group but not for the control group. Both groups showed significant improvements on 4-m gait speed (5.0 ± 0.9 s to 4.4 ± 0.9 s in the intervention group; 5.2 ± 2.9 to 5.0 ± 2.3 m in the control group;P<0.001). One patient reported a treatment-related bad taste in the intervention group.Conclusion:The findings of the present study demonstrated that the combined supplementation of creatinine, glutamine and HMB together with exercise training for 12 weeks may have a positive effect on the muscle mass and strength and QoL in adults with mild sarcopenia and OA. The results provide preliminary experiences and guidance for further clinical trials in both OA and sarcopenic patients.References:[1] Kemmler W, Teschler M, Goisser S, Bebenek M, von Stengel S, Bollheimer LC,et al. Prevalence of sarcopenia in Germany and the corresponding effect of osteoarthritis in females 70 years and older living in the community: results of the FORMoSA study.Clin Interv Aging. 2015;10:1565-73.Disclosure of Interests:None declared

Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

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BACKGROUNDHeart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF.METHODSThis is a real-world, before-and after-intervention trial, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before and after an intervention. The primary objective was the rate of readmissions, due to a HF event, post-intervention compared to pre-intervention. Secondary outcomes compared the rate of ED visits and the number of patients who had reduced NYHA score pre and post-intervention. A cost- analysis was also performed on these data.RESULTSAdmission rates significantly decreased by 41% after the intervention (total length of stay was reduced by 55%). The rate of ED visits was reduced by 55%. Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was €139,717.65 for the whole group over 1 year.CONCLUSIONSA personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care- associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.