30 Dynapenia and risk factors in Immune-Mediated Rheumatic Diseases: A Systematic Review

TL;DR

This study reviews how muscle strength loss (dynapenia) affects health in immune-mediated rheumatic diseases and finds it worsens clinical outcomes.

Contribution

The paper systematically reviews longitudinal studies to link dynapenia with clinical deterioration and adverse outcomes in immune-mediated rheumatic diseases.

Findings

Decreased muscle strength is associated with worsening clinical features in SLE and RA patients over time.

Low muscle strength is linked to multiple falls and reduced 5-year survival in RA patients.

Targeted exercise interventions could improve muscle strength and clinical outcomes in IMRDs patients.

Abstract

Dynapenia, the age-related decline in muscle strength, poses significant challenges to the quality of life, autonomy, and health of individuals, becoming a major public health concern. Immune-Mediated Rheumatic Diseases (IMRDs) patients often experience dynapenia, regardless of age. Therefore, our aims were to assess the association between changes in muscle strength and changes in clinical features in IMRDs. Additionally, to evaluate risk factors for adverse health outcomes in IMRDs. A systematic review of longitudinal studies published in English was conducted using PubMed, Embase, Web of Science and Scopus to November 2023. Search strategies were based on pre-defined keywords and medical subject headings. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale. Of 11.692 potential studies (5138 duplicate publication) screened for inclusion in the study, twenty-one were included. Of these 21 studies included, one study was with systematic sclerosis (Ss) patients, two studies were with systemic erythematosus lupus (SLE) patients and eighteen studies were with rheumatoid arthritis (RA) patients. The decrease in muscle strength was associated with worsening clinical features over time in both SLE and RA patients. Lastly, low muscle strength was linked to multiple falls and reduced 5-year survival in RA patients. Therefore, changes in muscle strength are associated with changes in clinical features over time, and low muscle strength is linked to adverse health outcomes. The study emphasizes the importance of targeted exercise interventions aimed at improving muscle strength to mitigate adverse health outcomes and enhance clinical features in IMRDs patients.