Medications associated with fracture risk in patients with rheumatoid arthritis

Liou, Yi‐Sheng; Lin, Tsung-Kun; Chen, Hung-Yi; Jong, Gwo‐Ping

doi:10.1136/annrheumdis-2019-216262

Cited by 4 publications

(5 citation statements)

References 21 publications

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“…Indeed, by blocking serotonin re-uptake, SSRIs exert central effects by increasing serotonin levels in the brain, thus improving depression, and also reduce disease severity in RA patients [ 79 ], as well as decrease arthritis scores in CIA mice by suppressing cytokine production from macrophages and synovial membrane cells [ 80 ]. However, a recent study indicated that the use of SSRIs is related to a higher risk of fractures in patients with RA [ 81 ].…”

Section: Tryptophan Metabolism and Ramentioning

confidence: 99%

Amino Acid Metabolism in Rheumatoid Arthritis: Friend or Foe?

et al. 2020

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In mammals, amino acid metabolism has evolved to act as a critical regulator of innate and adaptive immune responses. Rheumatoid arthritis (RA) is the most common form of inflammatory arthropathy sustained by autoimmune responses. We examine here the current knowledge of tryptophan and arginine metabolisms and the main immunoregulatory pathways in amino acid catabolism, in both RA patients and experimental models of arthritis. We found that l-tryptophan (Trp) metabolism and, in particular, the kynurenine pathway would exert protective effects in all experimental models and in some, but not all, RA patients, possibly due to single nucleotide polymorphisms in the gene coding for indoleamine 2,3-dioxygenase 1 (IDO1; the enzyme catalyzing the rate-limiting step of the kynurenine pathway). The function, i.e., either protective or pathogenetic, of the l-arginine (Arg) metabolism in RA was less clear. In fact, although immunoregulatory arginase 1 (ARG1) was highly induced at the synovial level in RA patients, its true functional role is still unknown, possibly because of few available preclinical data. Therefore, our analysis would indicate that amino acid metabolism represents a fruitful area of research for new drug targets for a more effective and safe therapy of RA and that further studies are demanding to pursue such an important objective.

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Section: Tryptophan Metabolism and Ramentioning

confidence: 99%

Amino Acid Metabolism in Rheumatoid Arthritis: Friend or Foe?

et al. 2020

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“…Although several risk factors have been identified in previous studies, previous investigations were subjected to either cross-sectional study [ 24 , 25 ], retrospective observation [ 1 ], limited variables included [ 25 , 26 ], small sample size [ 20 ] or self-reported outcome [ 27 ]. In our investigation, we included demographics, variables related to disease entity, lifestyle, medications used, fall history, and fracture risk factors in the FRAX ® tool that could be related to osteoporosis/fracture in our cohort to explore the possible risk factors for fracture in patients with RA.…”

Section: Discussionmentioning

confidence: 99%

Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study

Lin

Chen

et al. 2021

PLoS ONE

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Objectives To explore the risk factors for fragility fractures in rheumatoid arthritis (RA) patients using a 3-year longitudinal, observational cohort study. Methods This RA registry study included consecutive RA patients in the outpatient clinic of Chang Gung Memorial Hospital since September 1, 2014. The demographics, clinical characteristics, lifestyle, evidence of previous fracture, risk factors according to the Fracture Risk Assessment Tool (FRAX®), and the FRAX score of each participant were recorded. The participants were categorized into the new incident fracture (group A) and no incident fracture (group B) groups based on evidence or absence of new incident fractures and propensity score matching (age and gender, 1:2). Results Overall, 477 participants completed the 3-year observation period. After matching, 103 and 206 participants were allocated to groups A and B, respectively. The non-adjusted model revealed, presented as hazard ratio (HR) (95% confidence interval [CI]), that the presence of co-morbidity (1.80 [1.17–2.78], p = 0.008), Health Assessment Questionnaire Disability Index (1.35 [1.07–1.69], p = 0.010), lower baseline hip bone mineral density (0.11 [0.02–0.48], p = 0.004), longer disease duration (1.02 [1.00–1.04], p = 0.026), higher FRAX score of major fracture (1.03 [1.02–1.04], p<0.001) or hip fracture (1.03 [1.02–1.04], p<0.001), and previous fracture history (2.65 [1.79–3.94], p<0.001) were associated with new incident fracture. After adjustment, it was disclosed that a previous fracture is an independent risk factor for fragility fractures in RA patients (2.17 [1.20–3.90], p = 0.010). Conclusions In addition to aging and disease-related factors, previous fracture history is the most important risk factor for fragility fractures in RA patients.

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“…56 Glucocorticoids remain common and essential treatment for RA, although their prolonged low-dose usage raises the risk of cardiovascular disease, osteoporosis and fracture. [57][58][59] With the rapid advancement of RA treatment drugs, the multifaceted selection and combination of drugs provide more treatment possibilities for the personalized treatment of individuals with RA. In cases of severe RA with joint dysfunction, deformity or insufficient relief from conservative treatment, surgical interventions are often considered the primary approach to alleviate disease progression.…”

Section: Current Treatment Status Of Oa and Ramentioning

confidence: 99%

“…However, considering the potential long‐term immunosuppressive effects and increased risk of infection associated with MTX use, bDMARDs or tsDMARDs should be considered as alternative options for individuals with contraindications to MTX 56 . Glucocorticoids remain common and essential treatment for RA, although their prolonged low‐dose usage raises the risk of cardiovascular disease, osteoporosis and fracture 57–59 . With the rapid advancement of RA treatment drugs, the multifaceted selection and combination of drugs provide more treatment possibilities for the personalized treatment of individuals with RA.…”

Section: Current Treatment Status Of Oa and Ramentioning

confidence: 99%

Transient receptor potential vanilloid 1: A potential therapeutic target for the treatment of osteoarthritis and rheumatoid arthritis

Liao,

Umar,

Huang

et al. 2023

Cell Proliferation

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This study aims to determine the molecular mechanisms and analgesic effects of transient receptor potential vanilloid 1 (TRPV1) in the treatments of osteoarthritis (OA) and rheumatoid arthritis (RA). We summarize and analyse current studies regarding the biological functions and mechanisms of TRPV1 in arthritis. We search and analyse the related literature in Google Scholar, Web of Science and PubMed databases from inception to September 2023 through the multi‐combination of keywords like ‘TRPV1’, ‘ion channel’, ‘osteoarthritis’, ‘rheumatoid arthritis’ and ‘pain’. TRPV1 plays a crucial role in regulating downstream gene expression and maintaining cellular function and homeostasis, especially in chondrocytes, synovial fibroblasts, macrophages and osteoclasts. In addition, TRPV1 is located in sensory nerve endings and plays an important role in nerve sensitization, defunctionalization or central sensitization. TRPV1 is a non‐selective cation channel protein. Extensive evidence in recent years has established the significant involvement of TRPV1 in the development of arthritis pain and inflammation, positioning it as a promising therapeutic target for arthritis. TRPV1 likely represents a feasible therapeutic target for the treatment of OA and RA.

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Medications associated with fracture risk in patients with rheumatoid arthritis

Cited by 4 publications

References 21 publications

Amino Acid Metabolism in Rheumatoid Arthritis: Friend or Foe?

Amino Acid Metabolism in Rheumatoid Arthritis: Friend or Foe?

Risk factor analysis of fragility fractures in rheumatoid arthritis: A 3-year longitudinal, real-world, observational, cohort study

Transient receptor potential vanilloid 1: A potential therapeutic target for the treatment of osteoarthritis and rheumatoid arthritis

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