Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study

• Published in: Clinical rheumatology 2020-06, Vol.39 (6), p.1757-1764
• Main Authors: Yamada, Yutaro, Tada, Masahiro, Mandai, Koji, Hidaka, Noriaki, Inui, Kentaro, Nakamura, Hiroaki
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - physiopathology; Body Composition; Body Mass Index; Databases, Factual; Female; Glucocorticoids; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Health risk assessment; Humans; Logistic Models; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Observational studies; Original Article; Prospective Studies; Rheumatoid arthritis; Rheumatology; Risk Assessment; Risk Factors; ROC Curve; Sarcopenia; Sarcopenia - diagnosis; Sarcopenia - etiology; Sarcopenia - pathology
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-020-04929-4

Introduction Patients with rheumatoid arthritis (RA) are at higher risk of sarcopenia because of joint dysfunction and chronic inflammation. The present study aimed to investigate the predictors or risk factors for developing sarcopenia in RA patients using the prospective observational CHIKARA database. We hypothesized that older age, higher disease activity, lower physical function, and glucocorticoid (GC) use are risk factors for sarcopenia. Methods A total of 100 consecutive RA patients participated in the CHIKARA study. Their body compositions were examined using a body composition analyzer. Laboratory data, disease activity, physical function, and treatment were investigated. Sarcopenia was assessed at baseline and at 1 year. Predictors or risk factors for sarcopenia development at 1 year were investigated by univariate and multivariate analyses. Results Of 68 patients without sarcopenia at baseline, 9 (13.4%) developed sarcopenia over the year. Univariate analysis showed that age ( r  = 0.28, p  = 0.022), average GC dose over the year ( r  = 0.25, p  = 0.043), and body mass index ( r  = − 0.28, p  = 0.019) were significantly associated with the development of sarcopenia. Average GC use at ≥ 3.25 mg/day was a significant factor on multivariate analysis (odds ratio 8.81, 95% confidence interval 1.14–67.9, p  = 0.037). Conclusions RA patients using GCs at an average dose ≥ 3.25 mg/day over 1 year were at higher risk for developing sarcopenia. Reduction or withdrawal of GCs may prevent sarcopenia. Key Points • Patients with RA are at higher risk of sarcopenia. • Predictors or risk factors for developing sarcopenia over 1 year in RA patients were investigated using the prospective observational CHIKARA database. • RA patients using GCs at an average dose ≥ 3.25 mg/day over 1 year were at higher risk for developing sarcopenia. • Reduction or withdrawal of GCs may be essential to prevent sarcopenia.