To examine the prevalence of sarcopenia and its association with antirheumatic drugs in adults with rheumatoid arthritis (RA). This review was registered on PROSPERO and followed PRISMA guidelines. Electronic databases were searched for studies reporting on the prevalence of sarcopenia in adults with RA using any muscle index (muscle mass, strength and/or physical performance) and cutpoints as recommended by established criteria (EWGSOP1/2, AWGS, FNIH, SDOC). The secondary objective was to investigate the relationship between RA, antirheumatic drugs, and sarcopenia. Among 2240 middle-aged and older adults with RA (mean age: 47.7 ± 5.5 to 75.0 ± 6.2 years, 83.8% women), the pooled prevalence of low muscle mass/sarcopenia was 30.2% [95% confidence interval (CI) 24.2–36.2%; 16 studies; I²: 89.2%]. Sub-group analysis showed a non-significant higher prevalence of low muscle mass alone (32.6%, 95% CI 25.0–40.3%; I²: 87.9%) versus consensus definitions of sarcopenia (25.4%, 95% CI 15.4–35.3%; I²: 91.2%, p = 0.255). In adults with RA, corticosteroid use was positively associated with sarcopenia [odds ratio (OR) 1.46, 95% CI 0.94–2.29, 7 studies; I²: 47.5%] while conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) was inversely associated (OR 0.70, 95% CI 0.52–0.94; 6 studies: I²: 0.00%) with this muscle disease. No association was found for biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) (OR 0.83, 95% CI 0.54–1.30; 6 studies: I²: 47.6%). Sarcopenia is a common comorbidity of RA, and as such, clinicians should screen for this muscle disease in adults with RA. Further longitudinal studies are needed to understand the role of antirheumatic drugs (particularly type, dosing, and duration) in the development of sarcopenia.

研究类风湿性关节炎 (RA) 成人中肌肉减少症的患病率及其与抗风湿药物的关系。该评价在 PROSPERO 上注册并遵循 PRISMA 指南。使用任何肌肉指数（肌肉质量、力量和/或身体机能）和既定标准（EWGSOP1/2、AWGS、FNIH、SDOC）推荐的切点，在电子数据库中搜索报告成年 RA 肌肉减少症患病率的研究。次要目的是研究 RA、抗风湿药和肌肉减少症之间的关系。在 2240 名患有 RA 的中年和老年人（平均年龄：47.7 ± 5.5 至 75.0 ± 6.2 岁，83.8% 女性）中，低肌肉质量/肌肉减少症的合并患病率为 30.2% [95% 置信区间 (CI) 24.2– 36.2%；16 项研究；我²: 89.2%]。亚组分析显示，与肌肉减少症的共识定义（25.4%，95% CI 15.4–35.3%）相比，单独的低肌肉质量（32.6%，95% CI 25.0–40.3%；I ² : 87.9%）的发生率不显着更高；I ²：91.2%，p  = 0.255)。在成人 RA 中，皮质类固醇的使用与肌肉减少症呈正相关 [优势比 (OR) 1.46，95% CI 0.94–2.29，7 项研究；I ² : 47.5%] 而传统的合成疾病缓解抗风湿药物 (csDMARDs ) 与这种肌肉疾病呈负相关（OR 0.70，95% CI 0.52–0.94；6 项研究：I ² : 0.00%）。未发现生物/靶向合成疾病缓解抗风湿药 (b/tsDMARDs) 之间存在关联（OR 0.83，95% CI 0.54–1.30；6 项研究：I ²: 47.6%)。肌肉减少症是 RA 的常见合并症，因此，临床医生应在成人 RA 中筛查这种肌肉疾病。需要进一步的纵向研究来了解抗风湿药物（特别是类型、剂量和持续时间）在肌肉减少症发展中的作用。