Pharmacodynamics of  bisphosphonates in arthritis.
Inflammatory arthritis is a group of autoimmune diseases characterized by chronic inflammation of the joints. Rheumatoid arthritis, the most common form of arthritis, is associated with local joint destruction and systemic bone loss. Osteoclasts, the only cells of the body able to resorbe bone, are key players in these two types of bone loss. Bisphosphonates are analogs of pyrophosphate that inhibit osteoclast action and bone resorption. They are indicated in pathology associated with excess resorption. Besides their effect on bone they also exhibit extra-osseous properties, acting on tumor cells, inflammation and angiogenesis. As a result, they have been trialed in the context of arthritis. It is now clear that they do not have any significant direct effect on disease activity or pain. If their indication in the prevention of glucocorticoid-induced osteoporosis is clear, any beneficial effects on bone erosions are still controversial but interesting preliminary results warrant further investigations.
INSERM UMR-S957, Physiopathologie de la Résorption Osseuse et Thérapie des Tumeurs Osseuses Primitives, Faculté de Médecine, 1 rue Gaston Veil, 44035 Nantes cedex 1, France. benlegoff@gmail.com
Benoit
B
Le Goff
Dominique
D
Heymann
D000818:Animals; D001862:Bone Resorption / Q000188:drug therapy / Q000276:immunology; D002986:Clinical Trials as Topic / Q000379:methods; D004164:Diphosphonates / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy* / Q000276:immunology; D010010:Osteoclasts / Q000187:drug effects / Q000276:immunology
D004164:Diphosphonates