Osteoporosis International

, Volume 7, Supplement 3, pp 217–222

Osteoporosis in rheumatoid arthritis

  • Y. Suzuki
  • Y. Mizushima
Article

Summary

Periarticular osteopenia of appendicular bones occurs early in the course of RA.Loss of the balance between bone resorption and formation contributes to the development of perarticular osteopenia and might be mediated through increased production of cytokines and prostaglandins by the synovium and bone marrow. Generalized osteopenia isalso common and leads to an increased risk of fracture. Although the pathogenesis of this osteopenia is considered to be multifactorial, disease activity, immobility, corticosteroids and menopausal status are the important determinants.

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References

  1. 1.
    Bywaters EGL. The early radiological signs of rheumatoid arthritis. Bull Rheum Dis 1960;11:231–4.PubMedGoogle Scholar
  2. 2.
    Sambrook PN, Ansell BM, Foster S, Gumpel JM, Hesp R. Reeve J. Bone turnover in early rheumatoid arthritis. 2. Longitudinal bone density studies. Ann Rheum Dis 1985;44:580–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Robinson DR, Tashjian AM, Levine L. Prostaglandin stimulated bone resorption by rheumatoid synovia. J Clin Invest 1975; 56:1181–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Mizel SB, Dayer JM, Krane SM, Mergenhagen SE. Stimulation of rheumatoid synovial cell collagenase and prostaglandin production by purified lymphocyte-activating factor (interleukin-1). Proc Natl Acad Sci USA 1981;78:423–30CrossRefGoogle Scholar
  5. 5.
    Shimizu S, Shiozawa S, Shiozawa K, Imura S, Fujita T. Quantitative histologic studies on the pathogenesis of periarticular osteoporosis in rheumatoic arthritis. Arthritis Rheum 1985;28:25–31.CrossRefPubMedGoogle Scholar
  6. 6.
    Akatsu T, Takahashi N, Debari K, Morita I, Murota S, Nagata N, et al. Prostaglandins promote osteoclast-like multinucleated cell formation by a mechanism involving cyclic adenosine 3′,5′-monophosphate in mouse marrow cell cultures. J Bone Miner Res 1989;4:29–35.CrossRefPubMedGoogle Scholar
  7. 7.
    Pfeilschifter J, Chenu C, Bird A, Mundy GR, Roodman GD. Interleukin-1 and tumor necrosis factor stimulate the formation of human osteoclast-like cells in vitro. J Bone Miner Res 1989;4:113–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Miyasaka N, Sato K, Goto M, Sasano M, Natsuyama M, Inoue K, Nishioka K. Augmented interleukin-1 production and HLA-DR expression in the synovium of rheumatoid arthritis patients. Arthritis Rheum 1988;31:480–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Hirano T, Matsuda T, Tuner M, et al. Excessive production of interleukin-6/B cell stimulatory factor-2 in rheumatoid arthritis. Eur J Immunol 1988;18:1797–801.CrossRefPubMedGoogle Scholar
  10. 10.
    Dayer J-M, Krane SM, Graham R, Russell G, Robinson DR. Production of collagenase and prostaglandins by isolated adherent rheumatoid synovial cells. Proc Natl Acad Sci USA 1976;73:945–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Suzuki Y, Tanihara M, Ichikawa Y, et al. Periarticular osteopenia in adjuvant-induced arthritis: role of interleukin-1 in decreased osteogenic and increased resorptive potential of bone marrow cells. Ann Rheum Dis 1995;54:484–90.CrossRefPubMedGoogle Scholar
  12. 12.
    Nguyen L, Dewhirst FE, Hauschka PV, Stashenko P. Interleukin-lβ stimulates bone resorption and inhibits bone formation in vivo. Lymphokine Cytokine Res 1991;10:15–21.PubMedGoogle Scholar
  13. 13.
    Kennedy AC, Smith DA, Buchana WW, Anderson JB, Jasani MK. Bone loss in patients with rheumatoid arthritis. Scand J Rheumatol 1975;4:73–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Sambrook PN, Eisman J, Champion GD, Yeates MG, Pocock NA, Eberl S. Determinants of axial bone loss in rheumatoid arthritis. Arthritis Rheum 1987;30:721–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Compston JE, Crawley EO, Evance C, O’Sullivan MM. Spinal trabecular bone mineral content in patients with non-steroid treated rheumatoid arthritis. Ann Rheum Dis 1988;47:660–4.CrossRefPubMedGoogle Scholar
  16. 16.
    Mellish RWE, O’Sullivan MM, Garrahan NJ, Compston JE. Iliac crest trabecular bone mass and structure in patients with nonsteroid treated rheumatoid arthritis. Ann Rheum Dis 1987;46:830–6.CrossRefPubMedGoogle Scholar
  17. 17.
    Hooyman JR, Melton LJ, Nelson AM, O’Fallon WM, Riggs BL. Fractures after rheumatoid arthritis. Arthritis Rheum 1984;27: 1353–61.CrossRefPubMedGoogle Scholar
  18. 18.
    Spector TD, Hall GM, McCloskey EV, Kanis JA. Risk of vertebral fractures in women with rheumatoid arthritis. BMJ 1993;306:558.CrossRefPubMedGoogle Scholar
  19. 19.
    Weisman MH, Orth RW, Catherwood BD, Monolaga SC, Deftos LJ. Measures of bone loss in rheumatoid arthritis. Arch Intern Med 1986;146:701–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Sambrook PN. Ansell BM, Foster S, et al. Bone turnover in early rheumatoid arthritis. 1. Biochemical and kinetic indexes. Ann Rheum Dis 1985;44:575–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Ekenstam E, Ljunghall S, Höllgren R. Serum ostecalcin in rheumatoid arthritis and other inflammatory arthritides: relation between inflammatory activity and the effect of glucocorticoids and remission inducing drug. Ann Rheum Dis 1986;45:484–90.CrossRefPubMedGoogle Scholar
  22. 22.
    Compston JE, Vedi S, Mellish RWE, Croucher P, O’Sullivan MMO. Reduced bone formation in non-steroid treated patients with rheumatoid arthritis. Ann Rheum Dis 1989;48:483–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Gough AKS, Peel NFA, Eastell R, Holder RL, Lilley J, Emery P. Excretion of pyridinium crosslinks correlates with disease activity and appendicular bone loss in early rheumatoid arthritis. Ann Rheum Dis 1994;53:14–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Laan RFJM, Buijis WCAM, Verbeek ALM, et al. Bone mineral density in patients with recent onset rheumatoid arthritis: influence of disease activity and functional capacity. Ann Rheum Dis 1993;52:21–6.CrossRefPubMedGoogle Scholar
  25. 25.
    Gough AKS, Lilley J, Eyre S, Holder RL, Emery P. Generalised bone loss in patients with early rheumatoid arthritis. Lancet 1994;344:23–7.CrossRefPubMedGoogle Scholar
  26. 26.
    Kroger H, Honkanen R, Saarikoski S, Alhava E. Decreased axial bone mineral density in perimenopausal women with rheumatoid arthritis: a population based study. Ann Rheum Dis 1994;53:18–23.CrossRefPubMedGoogle Scholar
  27. 27.
    Kirwan JR, Arthritis and Rheumatism Council Low Dose Glucocorticoid Study Group. The effect of glucocorticoids on joint destruction in rheumatoid arthritis. N Engl J Med 1995;333:142–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Suzuki Y, Ichikawa Y, Saito E, Homma M. Importance of increased urinary calcium excretion in the development of secondary hyperparathyroidism of patients under glucocorticoid therapy. Metabolism 1983;32:151–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Sambrook PN, Jones G. Corticosteroid osteoporosis. Br J Rheumatol 1995;34:8–12.CrossRefPubMedGoogle Scholar
  30. 30.
    Sambrook PN, Cohen ML, Eisman JA, Pocock NA, Champion GD, Yeates MG. Effects of low dose corticosteroids on bone mass in rheumatoid arthritis. Ann Rheum Dis 1989;48:535–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Hall GM, Spector TD, Griffin J, Jawad ASM, Hall M, Doyle DV. The effect of rheumatoid arthritis and steroid therapy on bone density in postmenopausal women. Arthritis Rheum 1993;36:1510–6.CrossRefGoogle Scholar
  32. 32.
    Michel BA, Bloch DA, Fries JF. Predictors of fractures in early rheumatoid arthritis. J Rheumatol 1991;18:804–8.PubMedGoogle Scholar
  33. 33.
    Regab AH, Frech RS, Vietti TJ. Osteoporosis fractures secondary to methotrexate therapy of acute leukemia. Am J Dis Child 1973;126:489–90.Google Scholar
  34. 34.
    Stanisavljevic S, Babcock AL. Fractures in children treated with methotrexate for leukemia. Clin Orthop 1977;125:139–44.PubMedGoogle Scholar
  35. 35.
    May KP, West SG, McDermott MT, Huffer WE. The effect of low-dose methotrexate on bone metabolism and histomorphometry in rats. Arthritis Rheum 1994;37:201–6.CrossRefPubMedGoogle Scholar
  36. 36.
    Suzuki Y, Nakagawa M, Masuda C, et al. Short-term low-dose methotrexate ameliorates abnormal bone metabolism and bone loss in adjuvant-induced arthritis. J Rheumatol (in press).Google Scholar
  37. 37.
    Preston SJ, Diamond T, Scott A, Rodger Laurent M. Methotrexate osteopathy in rhumatic disease. Ann Rheum Dis 1993;52:582–5.CrossRefPubMedGoogle Scholar
  38. 38.
    Sambrook PN, Eisman JA, Champion GD, Pocock NA. Sex hormone status and osteoporosis in postmenopausal women with rheumatoid arthritis. Arthritis Rheum 1988; 31:973–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Sambrook PN, Abeyasekera G, Ansell BM, et al. Calcium absorption in rheumatoid arthritis. Ann Rheum Dis 1985;44:585–8.CrossRefPubMedGoogle Scholar
  40. 40.
    Verstraeten A, Dequeker J. Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroid. Ann Rheum Dis 1986;45:852–7.CrossRefPubMedGoogle Scholar

Copyright information

© European Foundation for Osteoporosis 1997

Authors and Affiliations

  • Y. Suzuki
    • 1
  • Y. Mizushima
    • 1
  1. 1.Institute of Medical ScienceSt. Marianna University School of MedicineKawasakiJapan

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