ASSESSING THE IMPACT OF SARCOPENIA IN AXIAL SPONDYLOARTHRITIS

Background: Patients with Axial Spondyloarthritis (AxSpA) face a potential risk of sarcopenia. Evidence suggests that chronic inflammation may contribute to its development, however data on the impact of the problem is limited. This knowledge gap emphasizes the need for additional research to contribute to the overall management improvement of these patients. The SARC-F questionnaire has been developed as a possible rapid diagnostic test for sarcopenia and it is recommended as a way of introducing the evaluation of this disease into clinical practice. Objectives: To analyze the prevalence of probable sarcopenia (PS) in a cohort of routinely managed AxSpA patients at a tertiary university hospital, and evaluate potential associated factors, as well as the sensitivity, specificity, predictive values and diagnostic accuracy of SARC-F questionnaire in the detection of PS in these patients. Methods: A prospective study included patients meeting ASAS classification criteria, aged ≥ 50, excluding extreme disability cases (wheelchair-bound), from November 2022 to November 2023. PS was defined according to the latest European Working Group on Sarcopenia in Older People (EWGSOP-2) consensus, in case of observing SARC-F ≥ 4 and grip strength < 27 kg in men and < 16 kg in women. Sociodemographic variables, clinical characteristics and outcome measures were collected. Differences between patients with and without PS were evaluated. Additionally, the sensitivity, specificity, predictive values and diagnostic accuracy of SARC-F questionnaire in the detection of PS were analyzed. Results: Seventy-five patients were included (74,7% male; mean age 64 ± 9 years; 36% smokers), with 65,3% engaging in regular exercise, and 9,3% having a history of fragility fracture. The majority of patients (81,3%) suffered ankylosing spondylitis. The frequency of PS was estimated at 9%. The mean SARC-F value was 2,3 ± 2,1. Fifty six patients (74,7%) presented a SARC-F < 4; 25% of these patients (14/56) additionally presented a low grip strength. Table 1 describes the general population characteristics and the comparison between groups based on the presence of PS. In the comparative analysis, a lower proportion of men was observed among patients with PS (25% vs 84.1). These patients had lower levels of hemoglobin (13,4 ± 1,3 vs 14,8 ± 1,7), higher disease activity (ASDAS CPR 3,8 ± 1,1 vs 1,9 ± 0,7; BASDAI 5,7 ± 1,8 vs 3 ± 1,9), worse functioning and health (ASAS-HI 9,1 ± 3,6 vs 5,3 ± 3,5; BASFI 5,7 ± 2 vs 3,5 ± 2,6), more fatigue (FACIT 29 ± 7,4 vs 39,2 ± 8,3) and poorer outcomes in the physical sphere of SF-12 questionnaire (30,9 ± 7,4 vs 43,5 ± 10). Table 2 describes the sensitivity, specificity, predictive values and the diagnostic accuracy of SARC-F questionnaire in the detection of PS. Conclusion: Sarcopenia is a relevant comorbid condition in AxSpA, and a connection with disease activity, functionality and fatigue seems to exist. In practice, SARC-F is a valuable screening tool for the evaluation of sarcopenia in patients with AxSpA. Considering sarcopenia in the overall management of AxSpA might help improve clinical care of patients. Table 1. General population characteristics and comparison between groups based on the presence of PS. Global (n=75) Patients without PS (n=63) Patients with PS (n=12) p-value Male 56 (74,7%) 53 (84,1%) 3 (25%) <0.001 Mean age 64 ± 9 64,1 ± 9,4 63,4 ± 7,2 0.803 Smokers 27 (36%) 25 (39,7%) 2 (16,7%) 0.383 Regular exercise 49 (65,3%) 39 (61,9%) 8 (66,7%) 0.390 Fragility fracture 7 (9,3%) 5 (7,9%) 2 (16,7%) 0.681 Ankylosing spondylitis 61 (81,3%) 52 (82,5%) 9 (75%) 0.850 Hemoglobin (g/dL) 14,6 ± 1,7 14,8 ± 1,7 13,4 ± 1,3 0.005 BASDAI 3,4 ± 2,1 3 ± 1,9 5,7 ± 1,8 <0.001 ASDAS CPR 2,1 ± 0,9 1,9 ± 0,7 3,8 ± 1,1 <0.001 ASAS-HI 5,9 ± 3,7 5,3 ± 3,5 9,1 ± 3,6 0.001 BASFI 3,83 ± 2,6 3,5 ± 2,6 5,7 ± 2 0.007 FACIT 37,5 ± 8,9 39,2 ± 8,3 29 ± 7,4 <0.001 SF-12 mental 49,4 ± 10,6 50,2 ± 10,8 45 ± 8,6 0.120 SF-12 physical 41,5 ± 10,7 43,5 ± 10 30,9 ± 7,4 <0.001 Table 2. Sensitivity, specificity, predictive values and diagnostic accuracy of SARC-F for the diagnosis of PS. Sensitivity Specificity PPV NPV Diagnostic accuracy SARC-F 0.889 1 1 0.631 0.906 PPV: positive predictive value, NPV: negative predictive value Acknowledgements: NIL. Disclosure of Interests: None declared. DOI: 10.1136/annrheumdis-2024-eular.2470 Keywords: Sarcopenia, Patient Reported Outcome Measures, Comorbidities Citation: , volume 83, supplement 1, year 2024, page 1782Session: Spondyloarthritis (Publication Only)

Sarcopenia, Patient Reported Outcome Measures, Comorbidities