Rheumatoid arthritis (RA) is an autoimmune disease, characterized by chronic and systemic inflammation. Besides, it is known that RA patients may present several comorbidities, such as sarcopenia, a condition where patients present both muscle mass and muscle quality impairment. RA treatment is mostly pharmacological and consists in controlling systemic inflammation and disease activity. Despite that, the effect of pharmacological treatment on sarcopenia is not well characterized. To summarize the effects of disease-modifying anti-rheumatic drugs (DMARDs) on skeletal muscle tissue in rheumatoid arthritis (RA) patients. A systematic review of randomized clinical trials and observational studies was conducted using MEDLINE, Embase, Cochrane Library, and Web of Science. We selected studies with rheumatoid arthritis patients treated with disease-modifying anti-rheumatic drugs (DMARDs) that analyzed muscle mass parameters such as lean mass and appendicular lean mass. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Standardized mean difference (SMD) and 95% confidence intervals (CI) were set. A meta-analysis of observational studies was performed using the R software, and we considered significant statistics when p < 0.05. Nine studies were included in this systematic review. In the meta-analysis, DMARD treatment had no positive difference (p = 0.60) in lean mass. In the same way, in the appendicular lean mass parameter, our results showed that DMARDs did not have changes between baseline and post-treatment analysis (p = 0.93). There is no evidence of a significant effect of DMARD therapy, either synthetic or biological, on muscle mass. However, this association should be investigated with more studies.

中文翻译：

---

改善疾病的抗风湿药对类风湿性关节炎患者骨骼肌质量的影响：系统评价和荟萃分析

类风湿性关节炎（RA）是一种自身免疫性疾病，以慢性和全身性炎症为特征。此外，众所周知，RA 患者可能会出现多种合并症，例如肌肉减少症，这是一种患者同时出现肌肉质量和肌肉质量受损的病症。RA 治疗主要是药物治疗，包括控制全身炎症和疾病活动。尽管如此，药物治疗对肌肉减少症的影响还没有得到很好的表征。总结疾病缓解抗风湿药 (DMARDs) 对类风湿关节炎 (RA) 患者骨骼肌组织的影响。使用 MEDLINE、Embase、Cochrane Library 和 Web of Science 对随机临床试验和观察性研究进行了系统回顾。我们选择了对接受疾病缓解抗风湿药 (DMARD) 治疗的类风湿性关节炎患者的研究，这些患者分析了肌肉质量参数，例如瘦体重和四肢瘦体重。使用纽卡斯尔-渥太华质量评估量表评估方法学质量。设置了标准化平均差 (SMD) 和 95% 置信区间 (CI)。使用 R 软件对观察性研究进行荟萃分析，当 p < 0.05 时，我们考虑了显着性统计。该系统评价纳入了 9 项研究。在荟萃分析中，DMARD 治疗在瘦体重方面没有正差异 (p = 0.60)。同样，在四肢瘦体重参数中，我们的结果表明 DMARD 在基线和治疗后分析之间没有变化 (p = 0.93)。没有证据表明 DMARD 疗法（无论是合成的还是生物的）对肌肉质量有显着影响。然而，这种关联应该通过更多的研究来调查。