POS0629 PREVALENCE AND FACTORS ASSOCIATED WITH SARCOPENIA IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Background: Sarcopenia is a progressive and generalized skeletal muscle loss associated with falls, fractures, physical disability, and mortality, described as age-related or secondary. Systemic infammatory diseases, such as rheumatoid arthritis (RA), are well-known causes of secondary sarcope-nia. However, the exact prevalence of sarcopenia in patients with RA is still unknown, partly due to the heterogeneous defnitions of sarcopenia adopted in different studies. Objectives: To 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. Methods: We 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 sar-copenia 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. Results: A 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 signifcantly associated with sarcopenia (β 0.68, p = 0.047, aOR 1.98, 95% CI 1.009-3.881) (Figure 1). We found a signifcant 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). Conclusion: Our 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 infammation. No correlation was found with b-DMARDs, possibly due to association with longer and more aggressive rheumatic disease.