[Osteoporosis associated with rheumatoid arthritis].
Patients with rheumatoid arthritis(RA) develop both generalized and periarticular osteoporosis. Both of them are believed to be associated with increased production of inflammatory cytokines(TNF alpha, IL-1 beta, IL-6) and increased formation and activation of osteoclasts. Whether glucocorticoids work positively or negatively on generalized/periarticular osteoporosis is still controversial. RANKL has been shown to be expressed on T cells and fibroblast-like cells in the synovium, thus 'RANKL-RANK' pathway is likely to play an important role in periarticular osteoporosis and bone erosion as well as generalized osteoporosis. Among various therapies for generalized/periarticular osteoporosis in RA, anti-cytokine antibodies/antagonists and osteoclast inhibitors including bisphosphonates are promising.
Kameda
Hideto
H
Second Department of Internal Medicine, Saitama Medical Center.
Takeuchi
Tsutomu
T
D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000378:metabolism; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy / Q000209:etiology*
D004164:Diphosphonates