Potential efficacy and preliminary mechanistic insights of the Jianpi Yishen Zhuanggu Tongluo formula for rheumatoid arthritis with sarcopenia-osteopenia: an integrated pilot study

Objectives: experiments. Methods: In this pilot study, forty RA-SO patients were randomly allocated into a treatment group (Group C, n = 20) receiving JPYSZGT plus conventional therapy and a control group (Group D, n = 20) receiving conventional therapy alone for 12 months. Clinical outcomes, including inflammatory markers (CRP, ESR), bone metabolism markers (CTX, PINP), insulin-like growth factor (IGF), cytokines (IL-6, TNF-α), bone mineral density (BMD), and appendicular skeletal muscle mass index (ASMI), were analyzed. Results: experiments suggested that JPYSZGT may suppress macrophage activation, potentially upregulate PINK1/PARKIN, downregulate OPG/RANK pathways, and reduce TNF-α and IL-6 secretion. Conclusion: This exploratory study suggests that JPYSZGT may improve bone-muscle metrics in RA-SO and that its potential mechanisms could involve the modulation of the PINK1/PARKIN, OPG/RANK, and PI3K/Akt pathways. It also appears to inhibit macrophage-driven inflammation. These findings warrant further investigation in larger-scale studies. Clinical Trial Registration: identifier ChiCTR2500106729.