Glucocorticoid usage is involved in the improvement and development of frailty in patients with rheumatoid arthritis: Results from the PRESENT study

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International Pub Date : 2025-07-31 DOI:10.1111/ggi.70137

Masahiro Tada, Yoshinari Matsumoto, Tatsuya Koike, Kenji Mamoto, Tomoyuki Nakamura, Shohei Anno, Takahiro Iida, Hitoshi Goto, Masanori Matsuura

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引用次数: 0

Abstract

Aim

This longitudinal cohort study examined the development and improvement of frailty. We analyzed baseline factors and 1-year changes to identify ways to prevent frailty and preserve quality of life in patients with rheumatoid arthritis.

Methods

A total of 160 patients with rheumatoid arthritis from the multicenter, prospective prospective observational cohort study were analyzed over a 1 year. Among the 104 robust or prefrail patients at baseline, those who progressed to frailty were classified as frailty development, whereas those who remained robust or prefrail were frailty undiagnosed. Among the 56 frail patients, those with improved frailty were classified as frailty improvement, and those who remained frail were classified as frailty continuation. The correlations between frailty development and improvement, baseline factors, and parameter changes were examined using univariate and multivariate logistic regression analyses.

Results

A total of 94 (90.4%) patients were frailty undiagnosed, and 10 (9.6%) were frailty development. Glucocorticoid usage (OR 6.21) and changes in the modified Health Assessment Questionnaire (ΔmHAQ; OR 1.49) were identified as a significant factor for frailty development adjusted for age, sex, disease activity score composite of the ESR and the 28-joint score, biological/targeted synthetic disease-modifying anti-rheumatic drug usage and mHAQ at baseline. A total of 28 (50.0%) patients were in the frailty continuation group, whereas 28 (50.0%) patients belonged were in the frailty improvement group. Glucocorticoid usage (OR 0.23) and ΔmHAQ (OR 0.75) were identified as significant factors for frailty improvement adjusted for age, sex, disease activity score composite of the ESR and the 28-joint score, biological/targeted synthetic disease-modifying anti-rheumatic drug usage, and mHAQ at baseline.

Conclusions

Avoiding glucocorticoid use and improvement of quality of life are key to preventing and overcoming frailty in patients with rheumatoid arthritis, and potentially extending their life expectancy. Geriatr Gerontol Int 2025; 25: 1231–1238.

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糖皮质激素的使用与类风湿关节炎患者虚弱的改善和发展有关：来自PRESENT研究的结果。

目的：本纵向队列研究探讨衰弱的发展和改善。我们分析了基线因素和1年的变化，以确定预防类风湿关节炎患者虚弱和保持生活质量的方法。方法：对来自多中心前瞻性前瞻性观察队列研究的160例类风湿关节炎患者进行为期1年的分析。在104名健康或虚弱的基线患者中，那些进展为虚弱的患者被归类为虚弱发展，而那些保持健康或虚弱的患者被归类为未确诊的虚弱。56例体弱患者中，体弱改善者为体弱改善者，体弱持续者为体弱延续者。采用单变量和多变量logistic回归分析，检验虚弱发展和改善、基线因素和参数变化之间的相关性。结果：94例（90.4%）患者未确诊为衰弱，10例（9.6%）为衰弱发展。糖皮质激素使用（OR 6.21）和修改后健康评估问卷的变化(ΔmHAQ；OR 1.49)被确定为衰弱发展的重要因素，经年龄、性别、ESR和28关节评分的疾病活动度评分、生物/靶向合成疾病改善抗风湿药物使用和基线时的mHAQ调整。衰弱延续组28例（50.0%），衰弱改善组28例（50.0%）。糖皮质激素使用（OR 0.23）和ΔmHAQ （OR 0.75）被确定为衰弱改善的重要因素，经年龄、性别、ESR和28关节评分的疾病活动度评分、生物/靶向合成疾病改善抗风湿药物使用和基线时的mHAQ调整后。结论：避免使用糖皮质激素和改善生活质量是预防和克服类风湿关节炎患者虚弱的关键，并有可能延长其预期寿命。Geriatr Gerontol 2025；••: ••-••.

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来源期刊

Geriatrics & Gerontology International 医学-老年医学

CiteScore

5.50

自引率

6.10%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.