Osteoporosis in Rheumatic Diseases: Anti-rheumatic Drugs and the Skeleton

Calcified Tissue International
Alanna M DubrovskyN E Lane

Abstract

Osteoporosis in rheumatic diseases is a very well-known complication. Systemic inflammation results in both generalized and localized bone loss and erosions. Recently, increased knowledge of inflammatory process in rheumatic diseases has resulted in the development of potent inhibitors of the cytokines, the biologic DMARDs. These treatments reduce systemic inflammation and have some effect on the generalized and localized bone loss. Progression of bone erosion was slowed by TNF, IL-6 and IL-1 inhibitors, a JAK inhibitor, a CTLA4 agonist, and rituximab. Effects on bone mineral density varied between the biological DMARDs. Medications that are approved for the treatment of osteoporosis have been evaluated to prevent bone loss in rheumatic disease patients, including denosumab, cathepsin K, bisphosphonates, anti-sclerostin antibodies and parathyroid hormone (hPTH 1-34), and have some efficacy in both the prevention of systemic bone loss and reducing localized bone erosions. This article reviews the effects of biologic DMARDs on bone mass and erosions in patients with rheumatic diseases and trials of anti-osteoporotic medications in animal models and patients with rheumatic diseases.

References

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Citations

Feb 9, 2019·Expert Review of Endocrinology & Metabolism·Luciano ColangeloSalvatore Minisola
Dec 12, 2019·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·A A van Bodegraven, N Bravenboer
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Jan 9, 2020·Calcified Tissue International·Zhi-Feng XiaoDing-Kun Lin
Jan 19, 2021·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·N GuañabensUNKNOWN OsteoResSer Working Group of the Spanish Society of Rheumatology
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Apr 30, 2021·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Stephan N SalzmannAlexander P Hughes

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Methods Mentioned

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