For example, glucocorticoids decrease muscle anabolism and increase muscle catabolism through different pathways, including the myostatin pathway, the IGF-1-PI3K-Akt pathway, and the NF-κB pathway [121]—thus, in particular patients showing significant RA cachexia, this treatment should be avoided or at least paired with therapy that may counter these undesired outcomes. Here, IGF1 is linked to rheumatoid arthritis.