Strategies for the prevention and treatment of osteoporosis in patients with rheumatoid arthritis.
Rheumatoid arthritis (RA) is a chronic disease that affects millions of patients worldwide. As better therapies emerge for treatment of this condition, patients with RA are living longer and are more likely to experience diseases associated with aging such as osteoporosis. The aetiology of osteoporosis in patients with RA is multifactorial, with some bone loss attributable to the underlying inflammatory disease. Patients may also experience bone loss that is a consequence of therapy with corticosteroids. Progress in the diagnosis and evaluation of osteoporosis has led to a greater awareness of this major health problem. There have also been many advances in our understanding of the pathophysiology of RA. However, recent studies have suggested that, despite our growing understanding of these diseases, therapies for preventing bone loss in this patient population are underutilised. Patients with RA, especially those taking corticosteroids or with persistent disease activity, must have their bone mass assessed with bone mineral density testing. RA patients with documented osteoporosis or those at high risk for the development of this potentially devastating complication should receive calcium and vitamin D supplementation as well as an anti-resorptive agent.
Phillips
Kristine
K
Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Aliprantis
Antonios
A
Coblyn
Jonathan
J
D000058:Accidental Falls / Q000517:prevention & control; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002116:Calcitonin / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D014807:Vitamin D / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D002116:Calcitonin; D002118:Calcium