Prevalence and factors associated with sarcopenia in patients with rheumatoid arthritis

Abstract

Objectives: Sarcopenia is characterized by loss of muscle strength and mass, leading to falls and adverse health outcomes. Our aim was to determine the prevalence of sarcopenia in patients with rheumatoid arthritis (RA) and to identify factors associated with sarcopenia in these patients.

Methods: A cross-sectional study of 388 consecutive women with RA was conducted, assessing muscle mass and strength, and walking speed. Falls and bone fractures sustained over the prior year were evaluated. The association between sarcopenia and RA characteristics, falls, and bone fractures was evaluated using logistic regression analyses.

Results: The prevalence of sarcopenia was 37.1% (14.7%, severe sarcopenia; 22.4%, sarcopenia), with 49.0% classified as having low muscle mass. The incidence of falls, fractures, and lower bone mineral density was higher in patients with than without sarcopenia. Age, RA duration, Steinbrocker’s stage, the high Mini-Nutritional Assessment-Short Form score and the use of biological disease-modifying anti-rheumatic drugs (bDMARDs) were independent factors associated with sarcopenia.

Conclusion: We confirmed that sarcopenia develops in a significant proportion of patients with RA. Age, longer disease duration, joint destruction and malnutrition were positively associated with sarcopenia, with the use of bDMARDs being negatively associated.

KEYWORDS:

• Biological disease-modifying anti-rheumatic drugs
• cachexia
• inflammatory cytokines
• rheumatoid arthritis
• sarcopenia

Acknowledgments

We thank S. Nakagawa and M. Iida for technical assistance.

Conflict of interest

M.H., T.F., M.F., and H.I. are affiliated with a department that is supported financially by five pharmaceutical companies (Mitsubishi Tanabe Pharma Co., Bristol-Myers K.K., Chugai Pharmaceutical Co., Ltd., AbbVie GK., and Eisai Co., Ltd.). M.H. has received grants and research support from Astellas Pharma, Inc. and Pfizer Japan, Inc. H.I. has received grants and research support from Astellas Pharma, Inc., Pfizer Japan, Inc., NTT communications, and Takeda Pharmaceutical Co., Ltd. T.F. has received grants and research support from Takeda Pharmaceutical Co., Santen Pharmaceutical Co., Ltd., Astellas Pharma, Inc., Asahi Kasei Pharma Corporation, and Daiichi Sankyo Co., Ltd. T.M. has received grants and research support from Asahi Kasei Pharma Corporation, Astellas Pharma Inc., Bristol-Myers Squibb K.K., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Pfizer Japan, Inc., Santen Pharmaceutical Co., Ltd., and Takeda Pharmaceutical Co., Ltd., and speakers bureau from AbbVie GK., Bristol-Myers Squibb K.K., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Pfizer Japan, Inc., and Takeda Pharmaceutical Co., Ltd. The sponsors were not involved in the study design; in the collection, analysis, and interpretation of data; in the writing of this manuscript; or in the decision to submit the article for publication. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

Additional information

Funding

This work was supported by JSPS KAKENHI [Grant Number JP15K20763].