Fall risk in rheumatoid arthritis revisited: A follow-up study focusing on sarcopenia and glucocorticoid use

OBJECTIVES: To re-evaluate fall incidence and its determinants in a contemporary cohort of ambulatory women with rheumatoid arthritis (RA) in a follow-up study based on our previously published cohort data. METHODS: We prospectively evaluated 124 ambulatory female patients aged ≥50 years with RA at a single institution in 2022-2023, monitoring falls for 1 year. Outcomes included patient characteristics, sarcopenia, disease activity, and physical function. Multivariable logistic regression and Firth-penalized logistic regression were used in sensitivity analysis to assess the interaction between sarcopenia and glucocorticoid (GC) use. RESULTS: The annual fall rate in the 2022-2023 cohort was lower than in our previous cohort (27.4% vs. 50.0%). History of falls (odds ratio [OR] 2.76, 95% confidence interval [CI] 1.02-7.45, P = 0.045) and hypnotics/anxiolytics use (OR 3.92, 95% CI 1.01-15.20, P = 0.048) were independent risk factors for falls. A significant interaction between sarcopenia and GC use was observed in the initial analysis but was no longer statistically significant in sensitivity analyses. CONCLUSIONS: Compared with our previously reported cohort, the contemporary RA cohort showed a lower fall rate and a different pattern of associated risk factors. Further research is needed to explore the potential interaction between sarcopenia and glucocorticoid use. The observed interaction should be considered exploratory.