Therapeutic advances in musculoskeletal disease · 2026
Long-term dynamic of muscle mass and its effectors in female patients with rheumatoid arthritis: a 5-year prospective cohort study.
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Pan Jie, Zhu Ying-Ying, Zou Yao-Wei, Wu Tao, Ouyang Zhi-Ming, Jia Pei-Wen, Lin Jian-Zi, Lu Ye, Yang Ying, Ma Jian-Da, Dai Lie
Аннотация
BACKGROUND: Rheumatoid arthritis (RA) patients with low muscle mass (myopenia) have a higher risk of physical dysfunction and poor prognosis. However, the evidence of longitudinal changes in muscle mass in female RA patients was scarce.
OBJECTIVES: This study aimed to explore the long-term muscle dynamics and their potential effectors in female RA patients.
DESIGN: A 5-year prospective cohort study.
METHODS: Female RA patients without a diagnosis of myopenia at baseline were included if they finished the time frame of 5-year follow-up and had at least 2 times of muscle assessments by bioelectric impedance analysis. Linear mixed-effect models (LMEM) were used to analyze the annual progression rates of the appendicular skeletal muscle index (ASMI).
RESULTS: There were 210 female RA patients included, with a mean age of 48.4 ± 10.9 years and a median disease duration of 48 (interquartile range (IQR) 19, 95) months. During the median follow-up time of 4.73 (IQR: 2.86-5.15) years, the multivariable-adjusted annual decline rate of ASMI was -0.021 (standard error (SE) 0.007) (95% CI: -0.034 to -0.007, p = 0.002), consistent with a 2.059% decrease of ASMI at 5-year follow-up relative to baseline. Subgroup analyses showed RA patients without sustained remission (-0.031 (SE 0.008) p = 0.0003, p for interaction = 0.022), and those with a total dose of glucocorticoids (equivalent dose of prednisone) >6052 mg (-0.050 (SE 0.017) p = 0.007, p for interaction = 0.049) have a higher annual decline rate of ASMI. There were 15.2% (n = 32) patients who experienced a transition from non-myopenia to myopenia during the follow-up. The transition proportion of RA patients with sustained remission was significantly lower than that of patients without sustained remission (3.2% vs 20.3%, p = 0.002), and patients with a total dose of glucocorticoids >6052 mg showed a higher transition risk than those without (31.5% vs 11.7%, p = 0.008).
CONCLUSION: Our findings firstly illustrated the annual decline rate of muscle mass in female RA patients from a 5-year longitudinal data, and revealed the potential effect of tight control of disease activity and less glucocorticoid use for delaying the loss of muscle mass.
OBJECTIVES: This study aimed to explore the long-term muscle dynamics and their potential effectors in female RA patients.
DESIGN: A 5-year prospective cohort study.
METHODS: Female RA patients without a diagnosis of myopenia at baseline were included if they finished the time frame of 5-year follow-up and had at least 2 times of muscle assessments by bioelectric impedance analysis. Linear mixed-effect models (LMEM) were used to analyze the annual progression rates of the appendicular skeletal muscle index (ASMI).
RESULTS: There were 210 female RA patients included, with a mean age of 48.4 ± 10.9 years and a median disease duration of 48 (interquartile range (IQR) 19, 95) months. During the median follow-up time of 4.73 (IQR: 2.86-5.15) years, the multivariable-adjusted annual decline rate of ASMI was -0.021 (standard error (SE) 0.007) (95% CI: -0.034 to -0.007, p = 0.002), consistent with a 2.059% decrease of ASMI at 5-year follow-up relative to baseline. Subgroup analyses showed RA patients without sustained remission (-0.031 (SE 0.008) p = 0.0003, p for interaction = 0.022), and those with a total dose of glucocorticoids (equivalent dose of prednisone) >6052 mg (-0.050 (SE 0.017) p = 0.007, p for interaction = 0.049) have a higher annual decline rate of ASMI. There were 15.2% (n = 32) patients who experienced a transition from non-myopenia to myopenia during the follow-up. The transition proportion of RA patients with sustained remission was significantly lower than that of patients without sustained remission (3.2% vs 20.3%, p = 0.002), and patients with a total dose of glucocorticoids >6052 mg showed a higher transition risk than those without (31.5% vs 11.7%, p = 0.008).
CONCLUSION: Our findings firstly illustrated the annual decline rate of muscle mass in female RA patients from a 5-year longitudinal data, and revealed the potential effect of tight control of disease activity and less glucocorticoid use for delaying the loss of muscle mass.