Почти каждый пятый пациент с ревматоидным артритом страдает саркопенией: результаты исследования

Nearly 1 in 5 patients with rheumatoid arthritis (RA) have sarcopenia, according to study results published in RMD Open. Risk factors include lower BMI, longer disease duration, higher glucocorticoid doses, higher rheumatoid factor (RF)-IgM, and male gender, while tocilizumab therapy and treatment with tumor necrosis factor inhibitors may lower incidence rates. In a cross-sectional study, researchers enrolled 978 adults (mean age, 60.1±12.2 years; 86.4% women) with RA from a single tertiary center in China between May 2025 and January 2026. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia (AWGS) 2025 criteria; clinical characteristics, disease activity, laboratory markers, medication use, and comorbidities were compared between patients with and without sarcopenia, and multivariable logistic regression identified independent factors associated with the disease. Within the patient cohort, sarcopenia prevalence was 18.6%. Compared with patients without sarcopenia, those with sarcopenia were older (62.7 vs 59.5 years), had lower BMI (19.7 vs 23.7 kg/m²), longer disease duration (14.6 vs 11.2 years), higher erythrocyte sedimentation rate (ESR; 27.1 vs 22.6 mm/hour), and a higher prevalence of osteoporosis (22.0% vs 9.7%). Disease activity scores, (DAS28-CRP, DAS28-ESR), C-reactive protein, anticyclic-citrullinated peptide (CCP) antibodies, and rheumatoid factor isotypes were not significantly different between groups. These findings suggest a potential role in helping rheumatologists identify patients with RA at risk for sarcopenia earlier and could provide preliminary information to support clinical decision-making on interventions and medication management for patients with RA. Patients with sarcopenia were less likely to receive TNF inhibitors (14.3% vs 21.1%) or tocilizumab (13.7% vs 20.7%) but received higher daily doses of prednisone (1.94 vs 1.17 mg/day). Multivariable analysis identified male gender, (OR, 9.14; 95% CI, 5.21–16.03), lower BMI (OR, 0.586; 95% CI, 0.534–0.643), longer disease duration (OR, 1.046; 95% CI, 1.025–1.069), and higher RF-IgM levels (ORs, 9.14, 0.586, 1.046, and 1.002, respectively) as independent factors associated with sarcopenia. Current prednisone use also increased the odds of sarcopenia (OR, 1.094), while treatment with tocilizumab or TNF inhibitors was independently associated with lower odds of sarcopenia (OR, 0.493 and 0.502, respectively). Study limitations include the cross-sectional design, which precludes causal inference; the lack of assessment of physical activity and nutritional status; and the absence of data on bone mineral density and vitamin D supplementation. “These findings suggest a potential role in helping rheumatologists identify patients with RA at risk for sarcopenia earlier,” the researchers concluded, “and could provide preliminary information to support clinical decision-making on interventions and medication management for patients with RA.” This article originally appeared on Rheumatology Advisor