[Repair of bone and articular destruction in rheumatoid arthritis]

Repair of bone and articular destruction in rheumatoid arthritis (RA) is major problem to treat RA patients recently. However bone destruction starts in early phase of disease duration in RA. Histological meta-analysis of synovium is one of a key to solve the problem in RA. We investigated synovial histology about five factors including synovial proliferation, pillonodular synovium, vascular proliferation, and fibrin deposit and lymphocyte infiltration. Disease duration and pilonodular synovium has significant correlation by multiple regression analysis (p = 0.018). Therefore pillonodular synovium is important to decrease bone destruction in RA. It is possible that biological treatment for RA is effective to bone and cartilage metabolism, however some cases do not improve bone metabolism. Further investigation needs to analyze the factors of efficacy of bone and cartilage metabolism.