Bone; Bone mass; Fractures; Inflammation; Osteoporosis; Rheumatoid arthritis; Geriatrics and Gerontology; Aging
Abstract :
[en] Normal bone remodeling depends of a balance between bone forming cells, osteoblasts and bone resorbing cells, the osteoclasts. In chronic arthritides and some inflammatory and autoimmune diseases such as rheumatoid arthritis, there is a great constellation of cytokines produced by pannus that impair bone formation and stimulate bone resorption by inducing osteoclast differentiation and inhibiting osteoblast maturation. Patients with chronic inflammation have multiple causes that lead to low bone mineral density, osteoporosis and a high risk of fracture including circulating cytokines, impaired mobility, chronic administration of glucocorticoids, low vitamin D levels and post-menopausal status in women, among others. Biologic agents and other therapeutic measures to reach prompt remission might ameliorate these deleterious effects. In many cases, bone acting agents need to be added to conventional treatment to reduce the risk of fractures and to preserve articular integrity and independency for daily living activities. A limited number of studies related to fractures in chronic arthritides were published, and future investigation is needed to determine the risk of fractures and the protective effects of different treatments to reduce this risk.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Messina, Osvaldo Daniel ; Collaborating Centre WHO, Investigaciones Reumatológicas y Osteológicas (IRO), Buenos Aires, Argentina ; International Osteoporosis Foundation (IOF), Buenos Aires, Argentina
Vidal, Maritza ; Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru. maritzavw@gmail.com
Adami, Giovanni; Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
Vidal, Luis Fernando; Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru ; Regional Advisory Council for Latin America - International Osteoporosis Foundation (IOF), Lima, Peru
Clark, Patricia; International Osteoporosis Foundation (IOF), Buenos Aires, Argentina ; Chief of Clinical Epidemiology Unit-Hospital Federico Gomez School of Medicine UNAM, Mexico City, Mexico
Torres, Jorge A Morales; Hospital Aranda de la Parra. León, Guanajuato, Mexico
Lems, William; Department of Rheumatology, Amsterdam UMC, Location VU University Medical Centre Amsterdam, Amsterdam, North-Holland, The Netherlands
Zerbini, Cristiano; Centro Paulista de Investigacao Clinica, São Paulo, Brazil
Arguissain, Constanza; Collaborating Centre WHO, Investigaciones Reumatológicas y Osteológicas (IRO), Buenos Aires, Argentina
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique
Lane, Nancy E; Center for Musculoskeletal Health, University of California at Davis School of Medicine, Sacramento, CA, 95817, USA
Language :
English
Title :
Chronic arthritides and bone structure: focus on rheumatoid arthritis-an update.
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