Pos0629 prevalence and Factors Associated With Sarcopenia in Patients With Rheumatoid Arthritis

Abstract

BackgroundSarcopenia is a progressive and generalized skeletal muscle loss associated with falls, fractures, physical disability, and mortality, described as age-related or secondary. Systemic inflammatory diseases, such as rheumatoid arthritis (RA), are well-known causes of secondary sarcopenia. However, the exact prevalence of sarcopenia in patients with RA is still unknown, partly due to the heterogeneous definitions of sarcopenia adopted in different studies.ObjectivesTo assess the prevalence of sarcopenia in a cohort of patients affected by RA, and to evaluate the influence of age, sex, comorbidity, disease duration and activity, antibody status and therapies on sarcopenia.MethodsWe conducted a retrospective observational study on adult patients affected by RA undergoing evaluation at our outpatient clinic from January 2009 and July 2021. All patients underwent dual-energy X-ray absorptiometry (DXA) for assessment of body composition; diagnosis of sarcopenia was defined using Skeletal Muscle Mass Index (SMI), as proposed by consensus EWGSOP2 (1). We collected relevant demographic, clinical, therapeutic, and laboratory data at the time of DXA. We excluded patients affected by neoplastic disorders and/or malnutrition. Binary logistic regression analysis was employed to define predictors and protective factors of developing sarcopenia.ResultsA total of 266 patients (82.7% women) with a median age of 58.4 (IQR 14.4) years were included in the study. The prevalence of sarcopenia was 27.44%. From the binary logistic regression analysis, we found that the use of oral glucocorticoids (GCs) at a daily dose > 3.25 mg of prednisone-equivalent was significantly associated with sarcopenia (β 0.68, p = 0.047, aOR 1.98, 95% CI 1.009 – 3.881) (Figure 1). We found a significant inverse correlation between conventional disease-modifying antirheumatic drug (c-DMARDs) and sarcopenia (β -0.71, p = 0.027) as well. Age, sex, disease duration, mean disease activity - expressed as disease activity score based on 28 joints (DAS-28), erosive and seropositive disease - and biologic disease-modifying antirheumatic drug (b-DMARDs) therapy were not predictors of sarcopenia, albeit seropositive status showed a correlation trend with increased prevalence of sarcopenia (p = 0.092).Figure 1.ConclusionOur study showed that sarcopenia is a common complication in RA. Glucocorticoid therapy was associated with an increased prevalence of sarcopenia, while c-DMARDs acted as protective factors, possibly decreasing chronic inflammation. No correlation was found with b-DMARDs, possibly due to association with longer and more aggressive rheumatic disease.References[1]Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16–31Disclosure of InterestsNone declared

Obesity, sarcopenia, and arthritis and the theory of relativity: comment on the article by Baker et al

“…If so, is rheumatoid sarcopenia a consequence of a more aggressive disease, and therefore, more difficult to treat, or can muscle mass, like adipose tissue, interfere with the therapeutic response? (5,6) The purpose of this letter is not to challenge Baker et al (1), whose article faithfully reflects what we have seen in clinical practice, but only to shed light on the importance for us to improve our ability to phenotype obesity. Metabolically healthy obese, sarcopenic obese, and normal weight obese are phenotypes (7) that rheumatologists need to know to better study and care for their patients.…”

“…Past studies have demonstrated that early access to evaluation and treatment is critical for better outcomes in patients with inflammatory rheumatic diseases (6). We would argue that a rheumatologist's expertise is far more valuable for these patients with inflammatory conditions.…”