Abstract
The article presents a review of cross-sectional studies and long-term prospective observations dedicated to changes in bone mineral density (BMD) in patients with rheumatoid arthritis (RA) and factors influencing it. The relationship between local bone loss (erosion count) and generalized BMD loss was noted. It is indicated that existing RA treatment strategies are aimed at suppressing inflammation rather than preventing bone resorption. There is evidence that anti-inflammatory therapy using glucocorticoids, methotrexate, and biologic DMARDs in combination with antiresorptive drugs (bisphosphonates and denosumab) helps prevent BMD loss and the progression of erosions. It is emphasized that osteoporosis in RA, which belongs to the immune-mediated secondary osteopathies, is one of the most frequent and serious complications of RA, which determine the unfavorable course and prognosis of the underlying disease.
Highlights
Что противовоспалительная терапия с использованием глюкокортикоидов, метотрексата, генно-инженерных биологических препаратов в комбинации с антирезорбтивными препаратами способствует предупреждению потери минеральной плотности кости (МПК) и прогрессирования эрозий
The article presents a review of cross-sectional studies and long-term prospective observations dedicated to changes in bone mineral density (BMD) in patients with rheumatoid arthritis (RA) and factors influencing it
It is indicated that existing RA treatment strategies are aimed at suppressing inflammation rather than preventing bone resorption
Summary
The article presents a review of cross-sectional studies and long-term prospective observations dedicated to changes in bone mineral density (BMD) in patients with rheumatoid arthritis (RA) and factors influencing it. [2], впервые использовавшие ДРА для диагностики ОП при РА, установили, что больные, страдающие этим заболеванием, имеют более низкие показатели МПК по сравнению со здоровым контролем. Исследование BEST показало, что через год наблюдения у больных с ранней стадией РА отмечалось снижение МПК в шейке бедра (ШБ), составившее у мужчин -1,4%, а у женщин – -1,5% [4].
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