Noninvasive techniques for assessing skeletal changes in inflammatory arthritis: bone biomarkers

Area of Science:

• Rheumatology
• Bone Metabolism
• Biochemistry

Background:

• Inflammatory arthritis, including rheumatoid arthritis (RA), causes systemic bone loss, osteoporosis, and joint erosion.
• Current disease activity and radiologic assessments are insensitive to skeletal changes.
• Biologic markers of bone turnover offer a promising approach to monitor skeletal status.

Purpose of the Study:

• To review the utility of biochemical markers in assessing skeletal changes in inflammatory arthritis.
• To evaluate the role of bone resorption markers in predicting joint damage progression in RA.
• To explore the potential of these markers in evaluating treatment effects.

Main Methods:

• Review of prospective studies on biochemical bone resorption markers.
• Analysis of associations between bone markers, disease activity, and radiologic progression in RA.
• Examination of the OPG/RANK-L system's role in bone resorption.

Main Results:

• New type I collagen-based bone resorption markers are available and well-characterized.
• Elevated bone resorption markers correlate with faster joint destruction in early RA, independent of inflammation.
• The OPG/RANK-L system is implicated in RA-associated bone erosion and progression.

Conclusions:

• Biochemical markers of bone resorption can predict joint damage progression in RA.
• These markers, with cartilage turnover markers, are crucial for assessing treatment impact on joint damage.
• Further research is needed to explore their value in other inflammatory arthritides like ankylosing spondylarthritis.