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Published on: April 24, 2020
Osteoporosis in inflammatory joint diseases
1Rheumatology Department, Cochin Hospital, Paris Descartes University, Paris, France. christian.roux@cch.aphp.fr
Summary
Inflammation in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) drives bone loss and osteoporosis. Controlling inflammation is key to reducing bone damage and fracture risk in these inflammatory joint diseases.
Area of Science:
- Rheumatology
- Bone Metabolism
- Inflammatory Arthritis
Background:
- Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are inflammatory joint diseases.
- Both conditions are associated with significant bone complications, including osteoporosis and increased fracture risk.
Purpose of the Study:
- To explore the impact of inflammation on bone complications in RA and AS.
- To highlight the role of inflammation in bone resorption and formation in these diseases.
Main Methods:
- Review of prospective data on RA patients.
- Analysis of bone loss mechanisms in RA and AS.
- Correlation of inflammation control with structural damage and bone loss.
Main Results:
- In RA, inflammation contributes to periarticular bone loss, erosions, systemic osteoporosis, and fractures, even in glucocorticoid-naive patients.
- Optimal inflammation control in RA reduces structural damage and bone loss.
- In AS, osteoporosis is an early event, and inflammation is the primary driver of bone loss, independent of glucocorticoid use.
Conclusions:
- Inflammation is a critical determinant of bone loss and osteoporosis in both RA and AS.
- Effective management of inflammation is crucial for mitigating bone complications and fracture risk in patients with inflammatory arthritis.
- AS also demonstrates inflammation's potential role in local bone formation, leading to ankylosis.
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