Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study

  • Yutaro Yamada
  • Masahiro TadaEmail author
  • Koji Mandai
  • Noriaki Hidaka
  • Kentaro Inui
  • Hiroaki Nakamura
Original Article



Patients with rheumatoid arthritis (RA) are at higher risk of sarcopenia because of joint dysfunction and chronic inflammation. The present study aimed to investigate the predictors or risk factors for developing sarcopenia in RA patients using the prospective observational CHIKARA database. We hypothesized that older age, higher disease activity, lower physical function, and glucocorticoid (GC) use are risk factors for sarcopenia.


A total of 100 consecutive RA patients participated in the CHIKARA study. Their body compositions were examined using a body composition analyzer. Laboratory data, disease activity, physical function, and treatment were investigated. Sarcopenia was assessed at baseline and at 1 year. Predictors or risk factors for sarcopenia development at 1 year were investigated by univariate and multivariate analyses.


Of 68 patients without sarcopenia at baseline, 9 (13.4%) developed sarcopenia over the year. Univariate analysis showed that age (r = 0.28, p = 0.022), average GC dose over the year (r = 0.25, p = 0.043), and body mass index (r = − 0.28, p = 0.019) were significantly associated with the development of sarcopenia. Average GC use at ≥ 3.25 mg/day was a significant factor on multivariate analysis (odds ratio 8.81, 95% confidence interval 1.14–67.9, p = 0.037).


RA patients using GCs at an average dose ≥ 3.25 mg/day over 1 year were at higher risk for developing sarcopenia. Reduction or withdrawal of GCs may prevent sarcopenia.

Key Points

• Patients with RA are at higher risk of sarcopenia.

• Predictors or risk factors for developing sarcopenia over 1 year in RA patients were investigated using the prospective observational CHIKARA database.

• RA patients using GCs at an average dose ≥ 3.25 mg/day over 1 year were at higher risk for developing sarcopenia.

• Reduction or withdrawal of GCs may be essential to prevent sarcopenia.


Bioelectrical impedance analysis Glucocorticoid Prospective observational study Rheumatoid arthritis Sarcopenia 



The authors greatly appreciate the cooperation of the patients with RA.


This study was supported by a Grant-in-aid for Osteoporosis and Quality of Life 2015 from the Japan Osteoporosis Foundation.

Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2020

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryOsaka City University Graduate School of MedicineAbeno-kuJapan
  2. 2.Department of Orthopedic SurgeryOsaka City General HospitalMiyakojima-kuJapan

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