Bone Loss, Osteoporosis, and Fractures in Patients with Rheumatoid Arthritis: A Review

Fardellone, Patrice; Salawati, Emad; Monnier, Laure Le; Goëb, Vincent

doi:10.3390/jcm9103361

Cited by 57 publications

(51 citation statements)

References 65 publications

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“…Their levels seem to correlate with the amount of body fat and fall in response to weight loss [ 38 ]. TNF-a and IL-1 have a significant role in the inflammation-induced bone loss [ 39 ]. Still, in our ERA patients, the effect of inflammation on bone mass was not observed yet, probably due to the early course of RA disease.…”

Section: Discussionmentioning

confidence: 99%

Structural and Functional Changes of Hands and Legs in Early Rheumatoid Arthritis

et al. 2021

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Background and Objectives: The aim of this study was to assess if there are structural and functional changes of hands and legs already in early rheumatoid arthritis (ERA), compared with the population-based control group. Additionally, we aimed to identify if the changes are symmetrical in hands and legs and if there are factors that are associated with these changes. The study was conducted, and, thus far, the results have been controversial. Materials and Methods: The study group consisted of 83 consecutive patients with ERA and 321 control subjects. Dual-Energy X-Ray Absorptiometry (DXA) machine was used to measure bone, lean and fat mass. Inflammation and bone markers, smoking and nutritional habits were assessed, to evaluate the effects of different factors. The 30-Second Chair Stand Test (30-CST) and the Handgrip Strength Test (HST) were used to estimate muscle strength. Results: The presence of ERA was associated with lower arm, leg lean mass and higher fat mass of arm, compared with control subjects. ERA was also associated with lower mean handgrip in HST and worse muscle strength of legs in the 30-CST. Bone mass changes were not so evident both in arms and legs. Smoking habits did not seem to have relevant effect on bone mass, muscle structural and functional changes, both on hands and legs. In ERA, lean mass of arm and leg was negatively associated with C-reactive protein (CRP). The intake of proteins in ERA was not associated with lean mass changes both in hands and legs. Conclusions: Structural and functional changes of hands and legs are different in ERA. ERA patients had higher fat mass of arm, lower lean mass of arm and leg and, accordingly, decreased muscle function. The lowering of lean mass of arm and leg in ERA was associated with the elevation of CRP.

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Section: Discussionmentioning

confidence: 99%

Structural and Functional Changes of Hands and Legs in Early Rheumatoid Arthritis

et al. 2021

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“…In RA, the peripheral joints suffer from chronic inflammatory reactions [ 1 ]. This inflammatory reaction within the joint synovium leads to the production of multiple cytokines (tumor necrosis factor, interleukins-1, interleukin-6(IL-6)), resulting in activation of osteoclast that can mediate bone destructions [ 8 ]. Also, the inflammation in the joints increases bone absorption and makes the patient susceptible to bone loss and osteoporosis development [ 9 ].…”

Section: Reviewmentioning

confidence: 99%

“…Until now, there are no anti-resorbing drugs that can arrest or change the progression of RA-related bone erosions, as erosions result from non-osteoclast effect mechanisms [ 3 ]. But we can decrease osteoporosis development and bone loss in RA patients by using anti-inflammatory treatment, including DMARDs, which could reduce joint inflammation and decrease the rate of bone loss in RA patients [ 8 , 29 ]. It is better to use corticosteroids for the short term and the lowest dose possible [ 29 , 12 ].…”

Section: Reviewmentioning

confidence: 99%

The Impact of Rheumatoid Arthritis on Bone Loss: Links to Osteoporosis and Osteopenia

Kareem

Botleroo

Bhandari

et al. 2021

Cureus

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Rheumatoid arthritis (RA) is an autoimmune chronic connective tissue disease that produces persistent systemic inflammation, with joint inflammation leading to function loss and joint destruction. Low bone mass causes skeletal bone loss, commonly referred to as osteopenia or osteoporosis.We conducted this literature review to examine the relationship between RA and osteoporosis and the variables contributing to this connection. We used articles from the US National Library of Medicine (PubMed), Google Scholar, Science Direct to access the required information. Eventually, our results concluded that RA could result in local periarticular and generalized bone loss. Many risk factors contribute to this association, such as chronic joints inflammation, glucocorticoid use, genetics, and estrogen hormone effects. Still, it is not clear yet whether this is due to a consequence of treatment, immobility, or the activity of the disease. There are many recommendations by the American College of Rheumatology for RA patients during the disease course to reduce the risk of osteoporosis development, which include early starts of disease-modifying anti-inflammatory drugs (DMARDs), doing a dual-energy x-ray (DXA) or quantitative ultrasound (QUS) for identifying a patient at risk of osteoporosis, taking vitamin D, calcium, and bisphosphonates. Further prospective studies and clinical trials are essential to provide a solid evidencebased recommendation that will help to prevent bone loss in RA patients.

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“…Looking more in depth to these inflammatory diseases, some of them, such as RA, are characterized by great production of numerous cytokines (interleukin-1, interleukin-6, tumor necrosis factor) in the synovium that, in turn, activate osteoclasts and mediate cartilage and bone destruction of the joints, with a systemic effect leading to generalized bone loss [ 86 ]. Besides osteoclasts, immune cells including macrophages, mastocytes, dendritic cells, monocytes, plasma cells and B, T helper 1 (Th1), and 17 (Th17) lymphocytes, actively participate in tissue resorption [ 87 , 88 ].…”

Section: Role Of Purine Enzymes In Bone Inflammatory Conditionsmentioning

confidence: 99%

In Search of a Role for Extracellular Purine Enzymes in Bone Function

et al. 2021

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Bone is one of the major tissues that undergoes continuous remodeling throughout life, thus ensuring both organic body growth during development and protection of internal organs as well as repair of trauma during adulthood. Many endogenous substances contribute to bone homeostasis, including purines. Their role has increasingly emerged in recent decades as compounds which, by interacting with specific receptors, can help determine adequate responses of bone cells to physiological or pathological stimuli. Equally, it is recognized that the activity of purines is closely dependent on their interconversion or metabolic degradation ensured by a series of enzymes present at extracellular level as predominantly bound to the cell membrane or, also, as soluble isoforms. While the effects of purines mediated by their receptor interactions have sufficiently, even though not entirely, been characterized in many tissues including bone, those promoted by the extracellular enzymes providing for purine metabolism have not been. In this review, we will try to circumstantiate the presence and the role of these enzymes in bone to define their close relationship with purine activities in maintaining bone homeostasis in normal or pathological conditions.

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Bone Loss, Osteoporosis, and Fractures in Patients with Rheumatoid Arthritis: A Review

Cited by 57 publications

References 65 publications

Structural and Functional Changes of Hands and Legs in Early Rheumatoid Arthritis

Structural and Functional Changes of Hands and Legs in Early Rheumatoid Arthritis

The Impact of Rheumatoid Arthritis on Bone Loss: Links to Osteoporosis and Osteopenia

In Search of a Role for Extracellular Purine Enzymes in Bone Function

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