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

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JOURNAL OF CLINICAL MEDICINE
卷 10, 期 6, 页码 -

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MDPI
DOI: 10.3390/jcm10061241

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rheumatoid arthritis; osteoporosis; joint destruction; DMARD; biologics

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Rheumatoid arthritis is a systemic autoimmune disease that causes bone and cartilage destruction and systemic osteoporosis. Treatments targeting tumor necrosis factor and Janus kinase inhibitors can prevent structural damage, while osteoporosis can be treated with bisphosphonates and anti-receptor activator of the nuclear factor-kappa B ligand antibody. Understanding the mechanisms underlying osteoporosis and joint destruction in rheumatoid arthritis can lead to improved care and new treatments.
In rheumatoid arthritis, a representative systemic autoimmune disease, immune abnormality and accompanying persistent synovitis cause bone and cartilage destruction and systemic osteoporosis. Biologics targeting tumor necrosis factor, which plays a central role in the inflammatory process, and Janus kinase inhibitors have been introduced in the treatment of rheumatoid arthritis, making clinical remission a realistic treatment goal. These drugs can prevent structural damage to bone and cartilage. In addition, osteoporosis, caused by factors such as menopause, aging, immobility, and glucocorticoid use, can be treated with bisphosphonates and the anti-receptor activator of the nuclear factor-kappa B ligand antibody. An imbalance in the immune system in rheumatoid arthritis induces an imbalance in bone metabolism. However, osteoporosis and bone and cartilage destruction occur through totally different mechanisms. Understanding the mechanisms underlying osteoporosis and joint destruction in rheumatoid arthritis leads to improved care and the development of new treatments.

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