NEARLY one in five people with rheumatoid arthritis also has sarcopenia, the progressive loss of muscle mass and strength, a study of almost a thousand patients finds, identifying who is most at risk and hinting that some biologic drugs may protect against it.
Muscle Loss in Rheumatoid Arthritis
People with rheumatoid arthritis (RA) are prone to sarcopenia, which erodes physical function and quality of life and may raise mortality. Chronic inflammation is thought to drive it, yet its prevalence under the latest diagnostic criteria was unclear. This study measured how common sarcopenia is in rheumatoid arthritis and which clinical factors mark it out.
Study Design and Sarcopenia Assessment
The cross-sectional study enrolled 978 patients with RA (mean age 60.1 years; 86.4% female) diagnosed by the 2010 ACR/EULAR criteria. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS) 2025 consensus, with bioelectrical impedance analysis measuring appendicular skeletal muscle mass and handgrip dynamometry gauging strength. Demographic details, clinical parameters, and medication use were recorded, and associations analysed by logistic regression. The observational design assessed patients at a single timepoint, with no intervention or follow-up.
Risk Factors and Protective Drugs
Sarcopenia affected 18.6% of patients (182 of 978). Male sex was strongly associated (odds ratio 9.140; 95% CI 5.211 to 16.029), as were longer disease duration (OR 1.046; 95% CI 1.025 to 1.069), higher RF-IgM level (OR 1.002; 95% CI 1.000 to 1.003), and higher prednisone dose (OR 1.094; 95% CI 1.033 to 1.159). Higher body mass index was protective (OR 0.586; 95% CI 0.534 to 0.643). Notably, use of tumour necrosis factor inhibitors (OR 0.502; 95% CI 0.312 to 0.808) and tocilizumab (OR 0.493; 95% CI 0.304 to 0.799) was each linked to lower odds of sarcopenia.
Guiding Earlier Identification
The authors concluded that sarcopenia is common in rheumatoid arthritis, with male sex, lower body mass index, longer disease, higher RF-IgM, and higher glucocorticoid use marking elevated risk. Tocilizumab and TNF inhibitors may reduce its incidence, hinting at a protective role worth further study. They advised the findings could help rheumatologists spot at-risk patients earlier, while cautioning that the small male subgroup (13.6%) limits how far the sex-related findings generalise.
Reference
Wang H et al. Prevalence of sarcopenia in patients with rheumatoid arthritis: a cross-sectional study. RMD Open. 2026;12:e006945.
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