THU0159 RISK FACTORS FOR DEVELOPING SARCOPENIA IN PATIENTS WITH RHEUMATOID ARTHRITIS AT 2 YEARS: FROM THE CHIKARA STUDY
Authors: Yutaro Yamada, Masahiro Tada, Koji Mandai, Noriaki Hidaka, Kentaro Inui, Hiroaki Nakamura
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Patients with rheumatoid arthritis (RA) are at higher risk of sarcopenia due to joint dysfunction and chronic inflammation. The prospective observational CHIKARA study (Correlation research of sarcopenia, skeletal muscle and disease activity in rheumatoid arthritis; registration number UMIN000023744) was started in 2016 to clarify the correlation between RA disease activity and sarcopenia. We reported that glucocorticoid use and low body fat were independent risk factors for developing sarcopenia at 1 year in RA patients last year. <h3>Objectives</h3> Risk factors for sarcopenia were investigated over a 2-year period this time. <h3>Methods</h3> 100 patients (78 female, average age 68 years) enrolled in the prospective CHIKARA study underwent examinations of body composition (body weight, muscle mass, fat mass, predicted bone mass, etc.; measured by a body composition analyzer (MC-780A; TANITA, Tokyo, Japan)), laboratory data, disease activity, Health Assessment Questionnaire (HAQ), and treatment condition at baseline and at 2 years. Sarcopenia was diagnosed using the criteria of the Asia Working Group on Sarcopenia. Of 64 patients without sarcopenia at baseline, those who developed sarcopenia at 2 years were identified, and risk factors were investigated by univariate and multivariate analyses. <h3>Results</h3> Six patients (9.4%) developed sarcopenia during the 2-year follow-up. Glucocorticoid use &gt;5 mg/day was significantly higher (p=0.009), and MMP3 (p=0.018) and HAQ (p=0.045) were significantly increased in the patients who developed sarcopenia during the 2-year follow-up. Sarcopenia development was significantly associated with male sex (r=0.28, p=0.03), age (r=0.27, p=0.03), glucocorticoid use &gt;5 mg/day (r=0.33, p&lt;0.01), CRP (r=0.33, p&lt;0.01) at baseline, ΔMMP3 (r=0.30, p=0.02), and ΔHAQ (r=0.25, p=0.04) on univariate analysis. Multivariate analysis identified no independent factors (Table 1) GC: glucocorticoids, CI: confidence interval, Δ: change from baseline to 2 year <h3>Conclusion</h3> Male sex, old age, glucocorticoid use &gt;5 mg/day, and high elevations of MMP3 and HAQ are associated with developing sarcopenia at 2 years in RA patients. <h3>References</h3> [1] Yamada Y., Tada M., Mandai K. et al. Glucocorticoid use is an independent risk factor for sarcopenia in patients with rheumatoid arthritis – from the CHIKARA study -. EULAR 2018 THU0181. [2] Chen LK., Liu LK., Assantachai P., et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014; 15: 95-101. <h3>Acknowledgement</h3> Yutaro Yamada <h3>Disclosure of Interests</h3> Yutaro Yamada Speakers bureau: Abbvie, Chugai, Mitsubishi Tanabe, Masahiro Tada Speakers bureau: Abbvie, Astellas Pharma, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical, Pfizer Japan, Takeda Pharmaceutical , Koji Mandai: None declared, Noriaki Hidaka: None declared, Kentaro Inui Speakers bureau: Takeda Pharmaceutical, Pfizer Japan, Daiichi-Sankyo Co.Ltd., Abbvie, Mitsubishi Tanabe Pharma Corporation, Janssen Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, Eisai Co.Ltd., Eli-Lilly, Nippon Kayaku Co.,Ltd., Maruho Co.,Ltd, Kaken Pharmaceutical Co.,Ltd., Hiroaki Nakamura: None declared