Explore the vast range of titles available.

Background:Osteosarcopenia is defined as osteoporosis combined with sarcopenia. Both osteoporosis and sarcopenia are risk factors for falls and fractures in healthy individuals1. The relationships of falls and fractures to osteosarcopenia in rheumatoid arthritis (RA) patients are unknown.Objectives:The synergistic effect of osteoporosis and sarcopenia and the impact of osteosarcopenia on falls and fractures in RA patients were investigated using four years of data from a longitudinal study.Methods:The data from a prospective, observational study (CHIKARA study: UMIN000023744) were examined. The patients were divided into four groups according to their baseline status: no sarcopenia and osteoporosis (SP-OP-); only sarcopenia (SP+OP-); only osteoporosis (SP-OP+); and both sarcopenia and osteoporosis (SP+OP+). Sarcopenia was diagnosed by the criteria of the Asia Working Group on Sarcopenia 20142. Patients with osteoporosis were defined as those having a therapeutic intervention for osteoporosis. The survival rate and Cox hazard ratio were analyzed using falls and fractures as endpoints, adjusted by age, sex, and body mass index.Results:A total of 100 RA patients (female 78%, mean age 66.1 years) were enrolled. The number of SP-OP-, SP+OP-, SP-OP+, and SP+OP+ patients was 45, 17, 27, and 11, respectively. Their baseline characteristics are shown in Table 1. A total of 35 patients had falls, and 19 patients had fractures during the four-year follow-up. The fall-free survival rate in the SP-OP-, SP+OP-, SP-OP+, and SP+OP+ groups was 75.6%, 64.7%, 51.9%, and 36.4%, respectively; that of the SP+OP+ group was significantly lower than that of the other groups (P=0.021) (Figure 1). The fracture-free survival rate in the SP-OP-, SP+OP-, SP-OP+, and SP+OP+ groups was 86.7%, 82.4%, 81.5%, and 54.5%, respectively. That of the SP+OP+ group was relatively lower than that of the other groups (P=0.121). The hazard ratio of falls was significantly increased in the SP+OP+ group by 3.32-fold (95%CI: 1.01-10.9) compared to that in the SP-OP- group, whereas that in the SP+OP- and SP-OP+ groups was 2.58-fold (95%CI: 0.75-8.8) and 2.29-fold (95%CI: 0.94-5.6) higher, respectively. There were no significant differences compared to the SP-OP- group. The hazard ratio of fractures in the SP+OP+ group was increased 2.73-fold (95%CI: 0.61-12.2) compared to that in the SP-OP- group.Table 1.Baseline characteristics of the four groupsSA-OP-SA+OP-SA-OP+SA+OP+P value*Female, %73.358.888.91000.027Age, years63 (49, 72)69 (60, 79)73 (64, 75)73 (65, 81)0.008Disease duration, years4.4 (1.0, 8.4)4.0 (1.3, 8.9)7.6 (1.5, 14.5)10.5 (3.2, 26.5)0.035DAS28-ESR3.14 (2.66, 3.70)3.55 (3.01, 4.65)3.93 (3.28, 4.63)3.53 (2.48, 3.89)0.01mHAQ0.25 (0, 0.375)0.375 (0.125, 0.875)0.375 (0.125, 0.875)0.5 (0.125, 0.875)0.065MTX, mg/week, rate (%)8.4 ± 2.9 (86.7)8.7 ± 3.5 (70.6)8.3 ± 2.8 (92.6)6.8 ± 1.0 (90.9)0.388Glucocorticoid, mg/day, rate (%)3.7 ± 1.9 (20.0)6.3 ± 1.8 (11.8)4.0 ± 1.7 (44.4)3.8 ± 1.8 (18.2)0.400Body mass index, kg/m223.4 ± 3.819.2 ± 2.321.7 ± 2.419.2 ± 2.0<0.001Data are shown as mean ± standard deviation (SD) or median (25th, 75th percentile).*: compared in four groups by Kruskal-Walls test.Figure 1.Fall-free survival rates of the four groups.[Figure omitted. See PDF]Conclusion:The survival rates with the endpoints of falls and fractures in RA patients with osteosarcopenia were lower during the four-year follow-up. In particular, the risk of falls increased with the synergistic effect of osteoporosis and sarcopenia in RA patients.References:[1]Dennison, E. M. et al. Fracture risk following intermission of osteoporosis therapy. Osteoporos Int 30, 1733-1743, doi:10.1007/s00198-019-05002-w (2019).[2]Chen, L. K. et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 15, 95-101, doi:10.1016/j.jamda.2013.11.025 (2014).Disclosure of Interests:None declared.

BackgroundWe have reported that a decrease in phase angle (PhA), an index of cell membrane fragility, nutritional status, and muscle strength, measured by bioelectrical impedance analysis (BIA), is associated with falls in patients with rheumatoid arthritis (RA) [1]. Since a decline in physical balance ability is thought to be related to falls, assessing physical balance ability is important, and in recent years, assessment of physical balance ability has been included in the diagnostic criteria for sarcopenia. The PhA reflects muscle status and may be related to physical balance ability, but the relationship between physical balance ability and the PhA in RA patients is unclear.ObjectivesTo examine the relationship between physical balance ability and the PhA in RA patients.MethodsA cross-sectional analysis of 89 RA patients (78% female, mean age: 66.7±14.3 years) was performed. The PhA was evaluated at 50 kHz on a BIA device (MC-780A; TANITA, Japan). Assessment of physical balance ability was performed with a muscle function analyzer (BM-220; TANITA), which can assess physical balance ability based on changes in load during standing up from a chair. Of the indices obtained by the muscle function analyzer, lateral balance was evaluated by dividing the lateral directional variation value (Vx mm/sec) by the load variation value (Vw kg/sec) (Vx/Vw). The balance score, which is the score of the stability time (stable time) from the point after the maximum load value and Vx/Vw compared to the reference value, was also assessed. The associations of PhA with Vx/Vw being above the median and the z-score of Vx/Vw and of the balance score being above -0.5 were tested by logistic regression analysis, and the association between Vx/Vw and the PhA as continuous variables was tested by multiple regression analysis. The cutoff value of PhA for the balance score z-score of -0.5 was calculated by receiver-operating characteristic (ROC) curve analysis.ResultsEven after adjusting for covariates (sex, age, BMI, ADL, disease activity, and medication status), the PhA was significantly associated with Vx/Vw greater than the median [odds ratio (OR): 0.44, 95% confidence interval (CI): 0.19-0.995)] and z-score > -0.5 (OR: 0.42, 95%CI: 0.19-0.93). Multiple regression analysis adjusted for covariates also showed that the PhA was significantly associated with Vx/Vw (β=-0.22, p=0.023). A balance score z-score ≥ -0.5 was significantly associated with a PhA above the 75th percentile (OR: 9.34, 95%CI: 1.45-60.1). The cutoff value of the PhA for a balance score z-score of -0.5 was 4.87° (AUC = 0.64, p = 0.32) for men and 4.30° (AUC = 0.78, p < 0.001) for women.ConclusionThe PhA may be associated with physical balance ability.Reference[1] Matsumoto Y, Tada M et al. The bioimpedance phase angle is more useful than sarcopenia as a predictor of falls in patients with rheumatoid arthritis: Results from a 2-y prospective cohort study. Nutrition, 2022;102:111729Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Background:Patients with rheumatoid arthritis (RA) have higher rates of sarcopenia and frailty than the general population because they have reduced muscle strength due to the disease. In RA patients, the relationship between and the prevalence of concomitant sarcopenia and frailty is unclear.Objectives:The characteristics of RA patients with sarcopenia and frailty were investigated to clarify their interrelationship.Methods:Background data from the multicenter, prospective, observational study, “The effect of biologics and JAK inhibitors on sarcopenia in RA (PRESENT Study),” were used. The Asian Working Group for Sarcopenia (AWGS) 2019 diagnostic criteria were used to diagnose sarcopenia and severe sarcopenia, and the Japanese-Cardiovascular Health Study (J-CHS) criteria were used for frailty and pre-frailty. Two hundred RA patients who required tight control were divided into those with or without sarcopenia or with or without frailty, and patients’ background characteristics, disease activity, treatment, body composition, and muscle function were compared. The interrelationship between sarcopenia and frailty was also examined.Results:The incidences of sarcopenia and severe sarcopenia were 20% and 10%, respectively. Those with sarcopenia were significantly older, had longer disease duration, more advanced Stage and Class, higher RF positivity, higher C-reactive protein (CRP) level, higher methotrexate (MTX) use, lower muscle and fat mass, and weaker grip strength (Table 1). On the other hand, the incidences of frailty and pre-frailty were 40% and 54%, respectively. The frailty group was significantly older, had more advanced Stage and Class, higher DAS28-ESR, higher mHAQ, higher CRP level, higher glucocorticoid usage rate, lower muscle mass, weaker grip strength, and slower walking speed (Table 2). Sarcopenia and frailty were combined in 10% of patients (50% of sarcopenia and 25% of frailty patients). A significant positive correlation was found between severe sarcopenia and frailty (correlation coefficient 0.31, p<0.001).Conclusion:In RA patients requiring enhanced therapy, the incidences of sarcopenia and frailty were 20% and 40%, respectively, and both were present in 10% of patients. In particular, patients with frailty had high disease activity and a marked decline in muscle function.Table 1.Characteristics of RA patients with and without sarcopeniaSarcopenia+ (n=40)Sarcopenia- (n=160)P valueAge, years75.5 (69.3, 81.6)68.0 (58.3, 75.0)<0.001**Disease duration, years6.0 (1.5, 15.0)4.0 (1.0, 9.0)0.009**Steinbrocker stageI:8, II:15, III:11, IV:6I:93, II:34, III:17, IV:16<0.001*Steinbrocker class1:11, 2:21, 3:8, 4:01:100, 2:48, 3:12, 4:0<0.001*RF positive, %85.066.20.021*CRP, mg/dl0.70 (0.29, 2.12)0.48 (0.13, 1.34)0.046**Methotrexate, mg/week, rate (%)7.5 ± 3.3 (57.5)8.6 ± 3.0 (73.8)0.044***Muscle mass, kg31.2 (29.2, 34.2)35.7 (32.7, 43.4)<0.001**Fat mass, kg13.9 (11.1, 18.3)17.6 (14.2, 21.9)<0.001**Estimated bone mass, kg1.7 (1.5, 2.0)2.2 (1.9, 2.5)<0.001**Basal metabolic rate, kcal971 ± 1391152 ± 204<0.001***Grip strength, kg12.8 ± 6.019.3 ± 8.5<0.001***Frailty, %50.036.90.149** Fisher’s exact test ** Mann-Whitney U-test *** Student T-testTable 2.Characteristics of RA patients with and without frailtyFrailty+ (n=79)Frailty- (n=121)P valueAge, years74.0 (63.0, 79.0)68.0 (57.0, 79.0)<0.001**Steinbrocker stageI:32, II:19, III:17, IV:11I:69, II:30, III:11, IV:110.031*Steinbrocker class1:28, 2:34, 3:17, 4:01:83, 2:35, 3:3, 4:0<0.001*DAS28-ESR5.13 ± 1.034.52 ± 1.17<0.001***mHAQ0.75 (0.25, 1.25)0.25 (0, 0.625)<0.001**CRP, mg/dl0.75 (0.26, 2.04)0.46 (0.11, 1.13)0.005**MMP3, ng/ml148.8 (97.0, 327.4)100.7 (66.1, 178.7)0.002**Glucocorticoid, mg/day, rate (%)4.0 ± 2.5 (36.7)3.6 ± 2.8 (21.5)0.023***Muscle mass, kg32.8 (30.5, 39.6)35.5 (33.1, 41.0)0.001**Estimated bone mass, kg1.9 (1.7, 2.4)2.1 (1.9, 2.5)0.001**Basal metabolic rate, kcal1061 ± 1911151 ± 2080.003***Grip strength, kg12.5 ± 5.920.9 ± 8.6<0.001***Walking speed, m/s0.8 ± 0.21.2 ± 0.2<0.001***Sarcopenia, %25.316.50.129** Fisher’s exact test ** Mann-Whitney U-test *** Student T-testREFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.

Background:We reported that creatine kinase (CK) levels were increased by JAK inhibitors in rheumatoid arthritis (RA) patients in a retrospective study 1. There are no reports of whether JAK selectivity makes a difference in CK elevation. The relationship between CK elevation by JAK inhibitors and changes in muscle mass is also unclear.Objectives:Whether JAK inhibitors increased CK levels was investigated in a multicenter, prospective, observational study. The relationship between CK elevation caused by JAK inhibitors and changes in muscle mass was also analyzed.Methods:The 0 and 24-week data from the multicenter, prospective, observational study, “Effects of Biologics and JAK Inhibitors on Sarcopenia in RA (PRESENT Study),” were analyzed. In 200 RA patients requiring enhanced therapy, changes in their CK levels and muscle mass were analyzed from the following three perspectives: (1) csDMARDs vs b-/ts-DMARDs; (2) JAK inhibitors vs biologics; and (3) among the five JAK inhibitors. Correlations of changes in CK and muscle mass were evaluated using Spearman’s rank correlation coefficient.Results:The patients’ median age was 70 years, the median duration of disease was 4.5 years, and the mean DAS28-ESR was 4.77. Data for 24 weeks were available for 191 patients. There were no significant differences in CK levels or muscle mass at week 0. (1) The change in the CK level was significantly greater in the b-/ts-DMARDs group than in the csDMARDs group (median 17.0 vs. 9.0 IU/L, p=0.001). (2) The change in CK levels was significantly greater in the JAK inhibitor group than in the biologic group (median 46.0 vs 10.0 IU/L, p<0.001). (3) There was no significant difference in the change in CK levels among the five JAK inhibitor groups (p=0.487) (Figure 1). The change in muscle mass was not significantly different in any comparison (1)-(3). No correlation was found between changes in CK levels by JAK inhibitors and muscle mass (p=0.503) (Figure 2). There were no cases of elevations in CK level of Grade 2 or higher (over 2.5 times the baseline value) at 24 weeks.Conclusion:In a multicenter, prospective, observational study, changes in CK levels were significantly greater with JAK inhibitors than with other treatments in RA patients. However, regardless of JAK selectivity, the CK level increase at 24 weeks was mild. The lack of correlation between CK level elevation caused by JAK inhibitors and changes in muscle mass is interesting, and its mechanism remains to be elucidated.REFERENCES:[1] Tada M, Okano T, Mamoto K, et al. POS0840 THE DIFFERENCE IN CREATINE KINASE ELEVATION CAUSED BY JAK INHIBITORS AND IL-6 INHIBITORS IN RHEUMATOID ARTHRITIS. 2023; 82:718-.Figure 1.Changes in CK levels with five JAK inhibitorsFigure 2.Correlation diagram of changes in CK levels and muscle mass in RA patients treated with JAK inhibitors (n=33)Acknowledgements:NIL.Disclosure of Interests:None declared.

Background:Patients with rheumatoid arthritis (RA) tend to have sarcopenia due to decreased muscle mass and function. We previously reported that 13.2% of RA patients without sarcopenia at baseline developed sarcopenia over a year using data from the prospective, observational CHIKARA study1.Objectives:The aim was to investigate sarcopenia status and the characteristics of RA patients longitudinally.Methods:Body composition, laboratory data, disease activity, physical function, treatment, and history of falls and fractures were investigated in 100 RA patients who participated in the CHIKARA study at baseline and at 4 years. The patients were divided into 4 groups depending on their sarcopenia status: no sarcopenia development (N group), sarcopenia development (S group), cured (C group), and persisted (P group).Results:Of the 77 RA patients who completed the survey, 48 were in the N group; their body mass index, skeletal muscle mass index, fat percentage, estimated bone mass, and body metabolization rate at baseline were significantly elevated. On the other hand, 6 patients were in the S group; 83.3% of them experienced fractures during the 4 years, significantly more than in the other groups. Ten patients were in the P group, and their baseline MMP-3 was significantly higher than in the other groups. Thirteen patients were in the C group. There were no differences among the 4 groups in disease activity and physical function (Table 1).Table 1.Characteristics of 77 RA patients by sarcopenia status at baseline and at 4-year follow-up.no development (n=48)development (n=6)cured (n=10)persisted (n=13)p valueBaseline age, years64.5 (57.8, 72)70.0 (65.5, 72.3)61.0 (54.5, 68.3)72 (68, 81)0.062 disease duration, years4.6 (1.1, 9.9)11.7 (2.8, 18.9)8.1 (4.2, 14.3)4.0 (2.2, 7.7)0.427 biologics use, %37.516.730.023.10.617 GC use, %27.116.710.023.10.678 MMP-3, ng/ml66.8 (51.8, 103)52.5 (40.0, 56.7)82.8 (57.8, 186)157.5 (90.8, 250)0.001 DAS28ESR3.43 ± 0.873.48 ± 1.323.36 ± 1.083.80 ± 1.270.661 mHAQ0.31 (0, 0.50)0.19 (0.03, 0.44)0.38 (0, 0.84)0.50 (0.25, 0.88)0.383 BMI, kg/m223.4 ± 3.621.6 ± 2.419.2 ± 1.619.5 ± 2.6<0.001 SMI, kg/m26.8 ± 0.86.2 ± 0.65.8 ± 0.55.7 ± 0.6<0.001 fat percentage, %30.4 ± 8.429.1 ± 9.123.9 ± 4.025.1 ± 8.30.046 estimated bone mass, kg2.2 (2.0, 2.4)1.9 (1.8, 2.1)2.0 (1.7, 2.1)1.7 (1.7, 1.9)0.012 BMR, kcal1100 (1031, 1197)1029 (918, 1070)1012 (917, 1057)934 (894, 1006)0.005Change during 4 years ΔDAS28ESR-0.34 ± 0.97-0.52 ± 0.98-0.60 ± 1.46-0.56 ± 1.140.834 ΔmHAQ0 (-0.25, 0.16)0.19 (0, 0.56)-0.06 (-0.44, 0.94)0 (-0.38, 0.38)0.357 ΔSMI, kg/m20.0 ± 0.3-0.6 ± 0.30.3 ± 0.4-0.0 ± 0.3<0.001 fall, %43.883.330.023.10.079 fracture, %14.683.320.023.10.002Data are shown as mean ± standard deviation (SD) or median (25th, 75th percentile).GC: glucocorticoids, BMI: body mass index, SMI: skeletal muscle mass index, BMR: body metabolization rate.Conclusion:Overall, 7.8% of RA patients developed sarcopenia during the 4-year follow-up period, and they developed fractures more frequently. Evaluation of sarcopenia is important for risk assessment of fractures.References:[1]Y Yamada, M Tada, K Mandai et al. Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study. Clin Rheumatol 2020 Jun;39(6):1757-1764.Disclosure of Interests:Yutaro Yamada: None declared, Masahiro Tada: None declared, Koji Mandai: None declared, Noriaki Hidaka: None declared, Hiroaki Nakamura Grant/research support from: Astellas and Asahi Kasei

Rheumatoid arthritis (RA) patients have a high frequency of sarcopenia, and they commonly have reduced physical function. We previously reported that the prevalence of sarcopenia was 28%, that of frailty was 18.9%, and that of pre-frailty was 38.9% in RA patients1,2, and 13.2% of RA patients developed sarcopenia within a year 3. To investigate the risk factors for new onset of sarcopenia, locomotive syndrome, and frailty in patients with RA and the course of each disease. Two-year follow-up data from the rural group of the prospective, observational CHIKARA study were used. Sarcopenia was diagnosed using the criteria of the Asian Working Group for Sarcopenia 2014, locomotive syndrome was diagnosed using locomotive 5, and frailty was diagnosed using the basic checklist. New onset of the disease over the 2-year follow-up period was studied, excluding cases that had the disease at baseline. Improvement was defined as cases with disease at baseline that no longer met the diagnostic criteria after 2 years. Differences in the characteristics of each disease were tested using the Chi-squared test and the paired t-test. The 81 patients with RA (82.7% female) had mean age 66.9±11.5 years, mean DAS28-ESR 2.9±1.2, methotrexate use in 81.5% (with a dose of 9.9±2.7 mg/week), and glucocorticoid (GC) use in 22.2% (with a dose of 3.1±1.7 mg/week). The baseline prevalence was 44.4% for sarcopenia, 35.8% for locomotive syndrome, and 25.9% for frailty, and the new onset rate was 4.4% for sarcopenia, 15.4% for locomotive syndrome, and 13.3% for frailty. Of the patients with each disease at baseline, 36.1% had sarcopenia, 20.7% had locomotive syndrome, and 33.3% had frailty, and of those with each disease at 2 years, 36.1% had sarcopenia, 20.7% had locomotive syndrome, and 33.3% had frailty. The new onset sarcopenia and locomotive syndrome groups had significantly higher rates of GC use (p=0.036, p=0.007, paired t-test) and significantly higher doses (p=0.01, p=0.001, paired t-test) than the groups without new onset sarcopenia and locomotive syndrome. High baseline disease activity was an independent predictor of new onset of locomotive syndrome on multivariate logistic regression analysis (OR=3.21, p=0.015). The new onset rates at 2 years were 4.4% for sarcopenia, 15.4% for locomotive syndrome, and 13.3% for frailty. In the new onset sarcopenia and locomotive syndrome groups, both GC use and dosage were significantly higher. [1]Tada M, et al. Matrix metalloprotease 3 is associated with sarcopenia in rheumatoid arthritis - results from the CHIKARA study. Int J Rheum Dis. 2018 Nov;21(11):1962-1969. [2]Tada M, et al. Correlation between frailty and disease activity in patients with rheumatoid arthritis: Data from the CHIKARA study. Geriatr Gerontol Int. 2019 Dec;19(12):1220-1225. [3]Yamada Y, et al. Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study. Clin Rheumatol. 2020 Jun;39(6):1757-1764. None declared

BackgroundFrailty is defined as degradation of physical and cognition function in elderly adult1. The characteristics of frailty include not only physical problems as co-morbidity and disability, but also mental and social problems. It is unclear of relationship between frailty and disease activity of patients with rheumatoid arthritis (RA).ObjectivesWe investigated the relative factors about frailty in patients with RA from a prospective observational study.Methods95 from 100 patients entered the CHIKARA study (Correlation researcH of sarcopenIa, sKeletal muscle and disease Activity in Rheumatoid Arthritis) were investigated by frailty check list (maximal score is 25). According to reported article, frailty was defined from 8 to 25 and pre-frailty was from 4 to 7, and normal was from 0 to 3. We investigated relationship of disease activity in frailty, pre-frailty and normal groups, and analysed the relative factors for frailty.ResultsThe prevalence of frailty, pre-frailty, and normal was 19%, 39% and 42%, respectively. The character of groups indicated at table 1. Frailty group was the oldest of three groups. Disease activity sore 28 erythrocyte sedimentation rate (DAS28ESR) and matrix metalloproteinase 3 (MMP3) of frailty group was higher than those of pre-frailty and normal groups. Whereas, modified health assessment questionnaire (mHAQ) of frailty group was lower than those of pre-frailty and normal groups. Normal was 66.6% and frailty was 6.7% in remission patients. However, Normal was 13.3% and frailty was 46.7% in moderate and high disease activity patients (figure 1). The prevalence of frailty was increased with disease activity. The relative factors for frailty were age, locomotive syndrome, DAS28ESR, mHAQ, and Steinbroker class, positively and leg muscle score and grip strength, negatively by univariate analysis. Steinbroker class (odds ratio: 3.25 95% CI: 1.11–9.51, p=0.031) and mHAQ (odds ratio: 1.29, 95% CI: 1.13–1.46, p<0.001) were independent relative factors by multivariate analysis.Abstract THU0169 – Table 1The character of frailty, pre-frailty, and normal in patients with RAFrailtyPre-frailtyNormalP value Age, years72.5±10.368.6±11.360.7±16.40.01Leg muscle score84.9±5.986.2±6.493.2±9.7<0.001Grip, kg12.6±6.917.7±7.118.1±6.20.013Locomotive 5 score11.1±5.86.4±4.92.6±4.0<0.001MMP3, ng/dl143.7±122.095.9±66.088.6±52.00.033DAS28ESR3.62±0.973.27±1.022.83±0.960.015mHAQ0.9±0.70. 4±0.20.1±0.1<0.001Sarcopenia,%3941180.063ConclusionsIt was revealed that frailty involved disease activity and physical function in patients with RA. Control of disease activity is important to prevent not only disease progression, but also frailty.Reference[1] Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci2001;56:M146–56.Disclosure of InterestNone declared

BackgroundThe falls ratio is higher among patients with sarcopenia than among healthy individuals. We reported that the prevalence of sarcopenia was 28% and locomotive syndrome (locomo) was 52% in patients with rheumatoid arthritis (RA)1. Whether patients with RA complicated by sarcopenia show a higher ratio of falls compared to those without sarcopenia remains unclear.ObjectivesWe investigated events of falls and fractures, and predictors of those events in patients with RA.MethodsWe used data from a prospective observational study (CHIKARA study, UMIN000023744) started in 2016. Sarcopenia was diagnosed using the criteria of the Asia Working Group on Sarcopenia2. We counted the number of patients and events of falls and fractures they had per year[A1], and investigated correlations between those events and disease activity, body composition and sarcopenia. Predictors at baseline influencing those events were analysed by uni- and multivariate analysis.ResultsParticipants comprised 100 patients with RA (females, 78%; mean age, 66.1 years). Falls occurred in 21 patients (19 women), as 33 events (mean, 2 times/patient). Fractures occurred in 4 patients (4 women), as 5 events. Table 1 shows predictors for falls, with positive correlations for bone mass index, obesity level, fat percentage, and locomo, and negative correlations for height, trunk muscle mass, and grip strength. No relationships were seen between falls and CRP, DAS28ESR, skeletal muscle mass, and sarcopenia. Height (odds ratio, 0.912; p=0.003) and obesity level (odds ratio, 1.04; p=0.006) were independent predictors by multivariate analysis (table 1). In terms of fracture events, falls was the only predictor (r=0.469, p=0.001).Abstract AB0373 – Table 1Predictors of falls in patients with RAUnivariateMultivariate RPOdds ratio95% CIP Body mass index0.1950.040Obesity revel0.1940.0401.0401.011–1.0690.006Fat percentage0.2110.025Locomotive syndrome0.2370.012Height−0.2630.0050.9120.858–0.9680.003Trunk muscle mass−0.1880.048Grip strength−0.1980.036CRP0.0630.512DAS28ESR−0.0080.932Skeletal muscle mass0.0910.337Sarcopenia−0.0930.327ConclusionsFalls have been reported as significantly more frequent with sarcopenia. However, no relationship was seen between fall events and sarcopenia in this study. We may need to evaluate not only skeletal muscle mass, but also muscle function to predict falls.References[1] Tada M, Yamada Y, Mandai K, et al. Relationship of matrix metalloprotease 3 titer and sarcopenia in patients with rheumatoid arthritis: data from the CHIKARA study. Eular2017:abstract THU0157.[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 InterestNone declared

BackgroundPatients 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.ObjectivesWe investigated risk factors for developing sarcopenia in patients with RA.MethodsWe 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.ResultsNine 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)Abstract THU0181 – Table 1Risk factors for developing sarcopenia in patients with rheumatoid arthritisUnivariateMultivariate R valuep valueOdds ratio95% CIP value GCDosage0.2170.035--->2 mg/day--8.01.2–54.80.034Body fat mass−0.2110.0400.780.61–0.980.037ΔCRP−0.2050.046---GC: glucocorticoids, CI: confidence interval, Δ: change from baseline to 1 yearConclusionsRA 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 InterestNone declared

We developed a new lead-free solder alloy, an Sn-Ag-Cu base to which a small amount of Ni and Ge is added, to improve the mechanical properties of solder alloys. We examined creep deformation in bulk and through-hole (TH) form for two lead-free solder alloys, Sn-3.5Ag-0.5Cu-Ni-Ge and Sn-3.0Ag-0.5Cu, at elevated temperatures, finding that the creep rupture life of the Sn-3.5Ag-0.5Cu-Ni-Ge solder alloy was over three times better than that of the Sn-3.0Ag-0.5Cu solder at 398 K. Adding Ni to the solder appears to make microstructural development finer and more uniform. The Ni added to the solder readily combined with Cu to form stable intermetallic compounds of (Cu, Ni)^sub 6^Sn^sub 5^ capable of improving the creep behavior of solder alloys. Moreover, microstructural characterization based on transmission electron microscopy analyses observing creep behavior in detail showed that such particles in the Sn-3.5Ag-0.5Cu-Ni-Ge solder alloy prevent dislocation and movement. [PUBLICATION ABSTRACT]