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Skeletal complications of rheumatoid arthritis

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Abstract

Rheumatoid arthritis (RA) is associated with local and systemic inflammation that induces many changes in the skeletal health. Locally, periarticular bone loss and juxta-articular bone erosions may occur while joint ankylosis, generalized bone loss, osteoporosis, and fractures may develop secondary to inflammation. The aim of this narrative review is to summarize the clinical evidence for abnormal skeletal health in RA, the effects of disease modifying anti-rheumatic drugs (DMARDS) on bone health, and the effects of drugs for the prevention or treatment of osteoporosis in the RA population.

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Abbreviations

ACPA:

Anti-citrullinated protein antibodies

BMD:

Bone mineral density

BMI:

Body mass index

CI:

95% confidence intervals

CT:

Computerized tomography

DMARDS:

Disease modifying anti-rheumatic drugs

DKK-1:

Dickkopf-related protein 1

FRAX:

Fracture risk assessment tool

GC:

Glucocorticoids

MRI:

Magnetic resonance imaging

OR:

Odds ratio

RA:

Rheumatoid arthritis

RANKL:

Receptor activator of NF-kB ligand

RF:

Rheumatoid factor

RR:

Relative risk

TNFα:

Tumor necrosis factor alpha

TKR:

Total knee replacement

THR:

Total hip replacement

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  1. University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    L. Heinlen & M. B. Humphrey

  2. Veterans Affairs Medical Center, Oklahoma City, OK, USA

    M. B. Humphrey

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  1. L. Heinlen
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  2. M. B. Humphrey
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Heinlen, L., Humphrey, M.B. Skeletal complications of rheumatoid arthritis. Osteoporos Int 28, 2801–2812 (2017). https://doi.org/10.1007/s00198-017-4170-5

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