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

Alanna M Dubrovsky1, Mie Jin Lim1,2, Nancy E Lane3,4

  • 1Center for Musculoskeletal Health, University of California at Davis Medical Center, Sacramento, CA, 95817, USA.

Calcified Tissue International
|February 23, 2018
PubMed

Insights

Biologic disease-modifying antirheumatic drugs (DMARDs) slow bone erosion in rheumatic diseases by reducing inflammation. Osteoporosis medications also show efficacy in preventing bone loss and reducing erosions in these patients.

Area of Science:

  • Rheumatology
  • Bone Metabolism
  • Immunology

Background:

  • Rheumatic diseases frequently cause osteoporosis, characterized by generalized and localized bone loss due to systemic inflammation.
  • Biologic disease-modifying antirheumatic drugs (DMARDs) target inflammatory cytokines, offering potential benefits for bone health in rheumatic conditions.

Purpose of the Study:

  • To review the impact of biologic DMARDs on bone mass and erosions in patients with rheumatic diseases.
  • To evaluate the efficacy of anti-osteoporotic medications in preventing bone loss and reducing erosions in rheumatic disease models and patients.

Main Methods:

  • Review of existing literature on biologic DMARDs (TNF, IL-6, IL-1 inhibitors, JAK inhibitors, CTLA4 agonists, rituximab) and their effects on bone.
  • Analysis of studies on osteoporosis treatments (denosumab, cathepsin K inhibitors, bisphosphonates, anti-sclerostin antibodies, hPTH 1-34) in rheumatic disease contexts.

Main Results:

  • Biologic DMARDs demonstrated a slowing effect on bone erosion progression.
  • Effects of biologic DMARDs on bone mineral density varied.
  • Anti-osteoporotic medications showed efficacy in preventing systemic bone loss and reducing localized bone erosions.

Conclusions:

  • Biologic DMARDs can mitigate bone loss and erosions in rheumatic diseases by controlling inflammation.
  • Established osteoporosis therapies hold promise for managing bone complications in patients with rheumatic diseases.
Keywords:
Ankylosing spondylitisAnti-osteoporotic medicationAnti-rheumatic drugBone lossOsteoporosisRheumatoid arthritis

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