Bone loss in osteoporosis and arthritis. Pathogenesis and therapeutic strategies

Bone makes up a framework that provides protection for internal body organs. The homeostasis of bone is maintained by balanced old bone resorption and new bone formation. However, this balance can be altered such as in postmenopausal women, patients with some cancers, and patients with chronic inflammatory conditions such as rheumatoid arthritis. In recent years, the management of chronic inflammatory conditions was revolutionized by the use of biologic therapies that target key pro-inflammatory proteins and/or pathways. However, whilst the anti-inflammatory effect of these biologic agents is well-established, their effect on bone loss is just emerging. The use of these agents highlights the relationship between the pathogenesis of chronic inflammation and bone loss. Here, we provide an overview of advances in understanding this relationship in patients with rheumatoid arthritis.