Bone Loss, Osteoporosis, and Fractures in Patients with Rheumatoid Arthritis: A Review.
Patrice FardelloneEmad M SalawatiLaure Le MonnierVincent GoebPublished in: Journal of clinical medicine (2020)
Rheumatoid arthritis (RA) is often characterized by bone loss and fragility fractures and is a frequent comorbidity. Compared with a matched population, RA patients with fractures have more common risk factors of osteoporosis and fragility fractures but also risk factors resulting from the disease itself such as duration, intensity of the inflammation and disability, and cachexia. The inflammatory reaction in the synovium results in the production of numerous cytokines (interleukin-1, interleukin-6, tumor necrosis factor) that activate osteoclasts and mediate cartilage and bone destruction of the joints, but also have a systemic effect leading to generalized bone loss. Regular bone mineral density (BMD) measurement, fracture risk assessment using tools such as the FRAX algorithm, and vertebral fracture assessment (VFA) should be performed for early detection of osteoporosis and accurate treatment in RA patients.
Keyphrases
- bone loss
- bone mineral density
- rheumatoid arthritis
- postmenopausal women
- risk factors
- body composition
- disease activity
- risk assessment
- end stage renal disease
- oxidative stress
- ankylosing spondylitis
- interstitial lung disease
- chronic kidney disease
- ejection fraction
- multiple sclerosis
- high resolution
- machine learning
- high intensity
- peritoneal dialysis
- systemic lupus erythematosus
- heavy metals
- mass spectrometry
- deep learning
- hip fracture
- human health
- patient reported outcomes
- idiopathic pulmonary fibrosis