title: Inflammatory rheumatic disorders and bone.
abstract: Inflammatory joint diseases such as rheumatoid arthritis, as well as other rheumatic conditions, such as systemic lupus erythematosus (SLE) and ankylosing spondylitis, comprise a heterogeneous group of joint disorders that are all associated with extra-articular side effects, including bone loss and fractures. The concept of osteoimmunology is based on growing insights into the links between the immune system and bone. The pathogenesis of osteoporosis in these patients is multifactorial. We have, more or less as an example, described this extensively for patients with SLE. High disease activity (inflammation) and immobility are common factors that substantially increase fracture risk in these patients, on top of the background fracture risk based on, among other factors, age, body mass index, and gender. Although no fracture reduction has been shown in intervention studies in patients with inflammatory rheumatic diseases, we present treatment options that might be useful for clinicians who are treating these patients.
authors.affiliation: Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands. iem.bultink@vumc.nl
authors.forename: Irene E M
authors.initials: IE
authors.lastname: Bultink
authors.forename: Marijn
authors.initials: M
authors.lastname: Vis
authors.forename: Irene E
authors.initials: IE
authors.lastname: van der Horst-Bruinsma
authors.forename: Willem F
authors.initials: WF
authors.lastname: Lems
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D010024:Osteoporosis / Q000209:etiology* / Q000628:therapy; D058866:Osteoporotic Fractures / Q000209:etiology / Q000517:prevention & control; D012216:Rheumatic Diseases / Q000150:complications*; D013167:Spondylitis, Ankylosing / Q000150:complications