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The effect of disease-modifying antirheumatic drugs (DMARDs) on bone homeostasis in rheumatoid arthritis (RA) patients

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Abstract

The autoimmune disease known as rheumatoid arthritis (RA) has been linked to the deterioration of bone. Bone erosion is a hallmark of RA and is linked to the severity of the disease as well as a poor functional result. Erosion of periarticular cortical bone is a common feature seen on plain radiographs of patients with RA. This characteristic feature is the result of excessive bone resorption and inadequate formation of bone. It has been determined that there is a complex interaction between the inflammatory condition seen in RA and bone destruction. Increased knowledge of the pathways and other mechanisms involved in osteoclastogenesis has resulted from advances in both animal and clinical investigations. Also, Biological and targeted medicines have modified RA’s bone metabolism. Here, we provide a narrative overview of the literature on the pathomechanisms of bone structure involved in biological and targeted treatments for RA and also, the clinical implications of disease-modifying antirheumatic drugs (DMARDs) are discussed. In light of the fact that these newer treatments present patients with RA with new possibilities for disease improvement and symptom control, it is imperative that additional rigorous evidence be gathered to provide a clinical reference for both patients and their treating physicians.

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Authors and Affiliations

  1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Ahmadreza Khoshroo & Nazanin Ramezani

  2. Orthopaedic Surgeon, Department of Orthopedics, Emam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Keyvan Ramezani & Moein Bonakdar

  3. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Niusha Moghimi

Authors
  1. Ahmadreza Khoshroo
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  2. Keyvan Ramezani
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  3. Niusha Moghimi
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  4. Moein Bonakdar
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  5. Nazanin Ramezani
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Contributions

AK and NR: contributed to the idea design, literature search, writing the manuscript. KR and NM: drafted the work. MB: contributed in drawing the figures.

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Correspondence to Nazanin Ramezani.

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Khoshroo, A., Ramezani, K., Moghimi, N. et al. The effect of disease-modifying antirheumatic drugs (DMARDs) on bone homeostasis in rheumatoid arthritis (RA) patients. Inflammopharmacol 31, 689–697 (2023). https://doi.org/10.1007/s10787-022-01088-7

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