Managing Osteoporosis and Joint Damage in Patients with Rheumatoid Arthritis: An Overview

Tanaka, Yoshiya

doi:10.3390/jcm10061241

Cited by 34 publications

(29 citation statements)

References 60 publications

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“…JAK inhibitors directly or indirectly inhibit osteoclast maturation by suppressing IFNβ-mediated signalling in osteoclasts and IL-6-mediated RANKL expression in synovial fibroblasts. Dendritic cell-derived osteoclasts stimulated by IL-4, GM-CSF, M-CSF and RANKL promote bone resorption as osteoclasts and T cell activation as antigen-presenting cells in the pathogenesis of chronic inflammatory and destructive synovitis, suggesting that dendritic cell-derived osteoclasts are also targets for JAK inhibitors in the suppression of bone erosion in RA 39 , 40 (Fig. 2 ).…”

Section: Jak Inhibition In Ramentioning

confidence: 99%

Janus kinase-targeting therapies in rheumatology: a mechanisms-based approach

et al. 2022

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The four Janus kinase (JAK) proteins and seven signal transducer and activator of transcription (STAT) transcription factors mediate intracellular signal transduction downstream of cytokine receptors, which are implicated in the pathology of autoimmune, allergic and inflammatory diseases. Development of targeted small-molecule therapies such as JAK inhibitors, which have varied selective inhibitory profiles, has enabled a paradigm shift in the treatment of diverse disorders. JAK inhibitors suppress intracellular signalling mediated by multiple cytokines involved in the pathological processes of rheumatoid arthritis and many other immune and inflammatory diseases, and therefore have the capacity to target multiple aspects of those diseases. In addition to rheumatoid arthritis, JAK inhibition has potential for treatment of autoimmune diseases including systemic lupus erythematosus, spondyloarthritis, inflammatory bowel disease and alopecia areata, in which stimulation of innate immunity activates adaptive immunity, leading to generation of autoreactive T cells and activation and differentiation of B cells. JAK inhibitors are also effective in the treatment of allergic disorders, such as atopic dermatitis, and can even be used for the COVID-19-related cytokine storm. Mechanism-based treatments targeting JAK–STAT pathways have the potential to provide positive outcomes by minimizing the use of glucocorticoids and/or non-specific immunosuppressants in the treatment of systemic immune-mediated inflammatory diseases.

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Section: Jak Inhibition In Ramentioning

confidence: 99%

Janus kinase-targeting therapies in rheumatology: a mechanisms-based approach

et al. 2022

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“…It is commonly held that high levels of pro-inflammatory cytokines and immune system dysregulation played a critical role in the progression of ORA ( 1 , 64 ). Thus, theoretically, the drugs that reduce inflammation, especially biological agents, may simultaneously alleviate inflammatory conditions and prevent bone loss ( 65 ). Although results are still debated, elucidation of these molecular mechanisms of ORA may facilitate the discovery of novel therapeutic strategies.…”

Section: Resultsmentioning

confidence: 99%

Mapping Knowledge Structure and Themes Trends of Osteoporosis in Rheumatoid Arthritis: A Bibliometric Analysis

et al. 2021

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Background: Rheumatoid arthritis is a chronic disabling disease characterized by chronic inflammation, articular cartilage destruction, and reduced bone mass. Multiple studies have revealed that the development of osteoporosis in rheumatoid arthritis (RA; ORA) patients could be led to a reduced quality of life and increased healthcare costs. Nevertheless, no attempt has been made to analyze the field of ORA research with the bibliometric method. This study aimed to provide a comprehensive overview of the knowledge structure and theme trends in the field of ORA research from a bibliometric perspective.Methods: Articles and reviews regarding ORA from 1998 to 2021 were identified from the Web of Science database. An online bibliometric platform, CiteSpace, and VOSviewer software were used to generate visualization knowledge maps including co-authorship, co-citation, and co-occurrence analysis. SPSS, R, and Microsoft Excel software were used to conduct curve fitting and correlation analysis, and to analyze quantitative indicators, such as publication and citation counts, h-index, and journal citation reports.Results: A total of 1,081 papers with 28,473 citations were identified. Publications were mainly concentrated in North America, Western Europe, and Eastern Asia. Economic strength is an important factor affecting scientific output. The United States contributed the most publications (213) with the highest h-index value (46) as of September 14, 2021. Diakonhjemmet Hospital and professor Haugeberg G were the most prolific institution and influential authors, respectively. Journal of Rheumatology was the most productive journal concerning ORA research. According to the burst references, “anti-citrullinated protein antibodies” and “preventing joint destruction” have been recognized as the hot research issues in the domain. The keywords co-occurrence analysis identified “teriparatide,” “interleukin-6,” “Wnt,” and “vertebral fractures” as the important future research directions.Conclusion: This was the first bibliometric study comprehensively summarizing the trends and development of ORA research. Our findings could offer practical sources for scholars to understand the key information in this field, and identify the potential research frontiers and hot directions in the near future.

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“…These findings were supported by preclinical studies, which showed that baricitinib has an osteoprotective effect, increasing mineralization in bone-forming cells [ 38 ]. We also reported that osteoclasts derived from dendritic cells by stimulation of IL-4, GM-CSF, M-CSF and receptor activator of NF-κB ligand (RANKL) played pathological roles in chronic inflammatory and destructive synovitis via osteoclastic bone resorption and that such dendritic cell-derived osteoclasts could be potential targets of JAK inhibitors [ 39 , 40 ].…”

Section: Targeted Synthetic Dmardsmentioning

confidence: 99%

Recent progress in treatments of rheumatoid arthritis: an overview of developments in biologics and small molecules, and remaining unmet needs

Tanaka

2021

Rheumatology

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Through treatment with biological DMARDs (bDMARDs) or targeted synthetic (tsDMARDs) such as Janus kinase (JAK) inhibitors in addition to MTX, clinical remission has become a realistic therapeutic goal for the majority of patients with RA, and sustained remission facilitates prevention of joint damage and physical dysfunction. Long-term safety and sustained inhibition of structural changes and physical dysfunction by bDMARDs have been reported. The development of next-generation bDMARDs and expansion of their indications to various autoimmune diseases are expected. Five JAK inhibitors show comparable efficacy to bDMARDs, and the latest ones are effective for overcoming difficult-to-treat RA regardless of prior medications. Patients treated with JAK inhibitors should be adequately screened and monitored for infection, cardiovascular disorders, thrombosis, malignancies and so on. Advances in therapeutic strategies, including the differential use of therapeutic drugs and de-escalation of treatment after remission induction, are prioritized.

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Managing Osteoporosis and Joint Damage in Patients with Rheumatoid Arthritis: An Overview

Cited by 34 publications

References 60 publications

Janus kinase-targeting therapies in rheumatology: a mechanisms-based approach

Janus kinase-targeting therapies in rheumatology: a mechanisms-based approach

Mapping Knowledge Structure and Themes Trends of Osteoporosis in Rheumatoid Arthritis: A Bibliometric Analysis

Recent progress in treatments of rheumatoid arthritis: an overview of developments in biologics and small molecules, and remaining unmet needs

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