THU0181 Glucocorticoid use is an independent risk factor for sarcopenia in patients with rheumatoid arthritis – from the chikara study -

Background 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. Objectives We investigated risk factors for developing sarcopenia in patients with RA. Methods We analysed baseline and 1 year data from the CHIKARA study. The body composition (body weight, muscle mass, fat mass, predicted bone mass, etc.) of 100 patients (78% women; mean age, 68 years) enrolled in this study was examined using a body composition analyzer (MC-780A; TANITA, Tokyo, Japan). Grip strength and walking speed were also measured. Laboratory data, disease activity, Health Assessment Questionnaire (HAQ) and treatment were investigated. Sarcopenia was diagnosed using the criteria of the Asia Working Group on Sarcopenia. Patients with sarcopenia onset at 1 year were detected and their characteristics were analysed. Predictors for development of sarcopenia were also investigated by uni- and multivariate analyses. Results Nine patients developed sarcopenia during 1 year. Glucocorticoid (GC) use was significantly more frequent among patients with sarcopenia onset (55.6%) than among those without sarcopenia onset (22.1%, p=0.029). Univariate analysis revealed that GC dosage (r=0.217, p=0.035), body fat mass at baseline (r=−0.211, p=0.040) and change in CRP at 1 year (r=−0.205, p=0.046) were significantly associated with sarcopenia onset. GC use >2 mg/day (Odds ratio (OR) 8.0, 95% confidence interval (CI) 1.2–54.8, p=0.034) and body fat mass (OR 0.78, 95% CI 0.61–0.98, p=0.037) were detected as significant factors by multivariate analysis. (table 1) Conclusions RA patients using GC at >2 mg/day or with low fat mass were more likely to develop sarcopenia. References [1] Inui K., Koike T, Tada M, et al. Sarcopenia is apparent in patients with rheumatoid arthritis, especially those with biologics -TOMORROW study-. EULAR2015abstract (AB0359). [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 Assoc2014;15:95–101. Disclosure of Interest None declared