The Impact of Rheumatoid Arthritis on Bone Loss: Links to Osteoporosis and Osteopenia

Abstract

Rheumatoid arthritis (RA) is an autoimmune chronic connective tissue disease that produces persistent systemic inflammation, with joint inflammation leading to function loss and joint destruction. Low bone mass causes skeletal bone loss, commonly referred to as osteopenia or osteoporosis.We conducted this literature review to examine the relationship between RA and osteoporosis and the variables contributing to this connection. We used articles from the US National Library of Medicine (PubMed), Google Scholar, Science Direct to access the required information. Eventually, our results concluded that RA could result in local periarticular and generalized bone loss. Many risk factors contribute to this association, such as chronic joints inflammation, glucocorticoid use, genetics, and estrogen hormone effects. Still, it is not clear yet whether this is due to a consequence of treatment, immobility, or the activity of the disease. There are many recommendations by the American College of Rheumatology for RA patients during the disease course to reduce the risk of osteoporosis development, which include early starts of disease-modifying anti-inflammatory drugs (DMARDs), doing a dual-energy x-ray (DXA) or quantitative ultrasound (QUS) for identifying a patient at risk of osteoporosis, taking vitamin D, calcium, and bisphosphonates. Further prospective studies and clinical trials are essential to provide a solid evidencebased recommendation that will help to prevent bone loss in RA patients.

Anti-osteoporosis effects and regulatory mechanism of Lindera aggregata based on network pharmacology and experimental validation

“…It has been demonstrated that many risk factors contribute to this association, such as glucocorticoid use, estrogen hormone effects, chronic joints inflammation, and genetics. 59 Furthermore, OP is one of the most severe comorbidities of RA. 60 The KEGG results in this study also illustrated that the RA signaling pathway is the core pharmacological mechanism of RLA against OP and four OP-related genes were regulated by RLA.…”

“…It has been demonstrated that many risk factors contribute to this association, such as glucocorticoid use, estrogen hormone effects, chronic joints inflammation, and genetics. 59 Furthermore, OP is one of the most severe comorbidities of RA. 60 The KEGG results in this study…”

Aggravating factors for osteoporosis; a brief overview of the current findings

“…Rheumatoid arthritis: rheumatoid arthritis is an autoimmune disorder that can lead to joint damage and bone loss, increasing the risk of osteoporosis (18).…”

Propionibacterium freudenreichii Inhibits RANKL-Induced Osteoclast Differentiation and Ameliorates Rheumatoid Arthritis in Collagen-Induced Arthritis Mice

“…RA is an autoimmune disorder that attacks the body's defense system and primarily causes inflammation in the joints of the knee or fingers. In addition, RA affects other organs, including the eyes, lungs, and heart, and RA-induced chronic inflammation can impact bone absorption and osteolysis [2]. Currently, no available drug can completely cure RA.…”

“…RA-induced symptoms include joint swelling, pain, and joint stiffness [2]. Since the most typical symptoms of RA are inflammation and pain, the studies for developing treatment drugs have focused mainly on reducing inflammation status [3,5].…”