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The Impact of Conventional and Biological Disease Modifying Antirheumatic Drugs on Bone Biology. Rheumatoid Arthritis as a Case Study

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Abstract

The bone and the immune system have a very tight interaction. Systemic immune-mediated inflammatory diseases, such as rheumatoid arthritis (RA), induce bone loss, leading to a twofold increase in osteoporosis and an increase of fragility fracture risk of 1.35–2.13 times. This review focuses on the effects of conventional and biological disease modifying antirheumatic drugs (DMARDs) on bone biology, in the context of systemic inflammation, with a focus on RA. Published evidence supports a decrease in osteoclastic activity induced by DMARDs, which leads to positive effects on bone mineral density (BMD). It is unknown if this effect could be translated into fracture risk reduction. The combination with antiosteoclastic drugs can have an additional benefit.

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Authors and Affiliations

  1. Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal

    Sofia Carvalho Barreira & João Eurico Fonseca

  2. Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal

    Sofia Carvalho Barreira & João Eurico Fonseca

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Sofia Barreira declares that she has no conflict of interest.

João Eurico Fonseca has received research grants and/or acted as a speaker for Pfizer, MSD, Amgen, Abbvie, UCB, and Roche.

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Barreira, S.C., Fonseca, J.E. The Impact of Conventional and Biological Disease Modifying Antirheumatic Drugs on Bone Biology. Rheumatoid Arthritis as a Case Study. Clinic Rev Allerg Immunol 51, 100–109 (2016). https://doi.org/10.1007/s12016-016-8547-6

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