RESEARCH - Osteoporosis and erosive bone loss: a complicated relationship

[Guest guest]

Osteoporosis and Erosive Bone Loss: A Complicated Relationship

Deane, MD

Posted: 17 Dec 2009

Study Summary

In rheumatoid arthritis (RA), focal erosions develop as a result of

complicated interactions between cells and cytokines/chemokines in the

synovium and surrounding tissue, leading to bone destruction. In

addition to joint destruction, RA is also associated with osteoporosis

and an at least a twofold increased risk for fracture.[1] Because both

focal joint erosions and osteoporosis involve inflammatory and

cellular processes, it may be that the mechanisms which lead to focal

joint erosions may also lead to generalized osteoporosis. These

authors sought to quantify the relationship between focal joint

erosions and generalized osteoporosis in postmenopausal women with RA.

Exploring the relationship between erosions and osteoporosis in RA may

help clinicians (1) assess the risk for osteoporosis and fracture in

patients with erosive RA, (2) understand common pathophysiologic

mechanisms for erosions and generalized bone loss, and (3) identify

therapies that may be beneficial for both conditions.

For this analysis, women with RA were selected from a larger

longitudinally followed cohort if they were postmenopausal and not

currently taking therapy for osteoporosis (raloxifene,

bisphosphonates, hormone replacement, or calcitonin), but they may

have been on calcium and vitamin D supplementation. Each subject

selected for bone mineral density (BMD) assessment had hand x-ray

performed every 2 years as part of the original study protocol, and

had hip and lumbar spine dual x-ray absorbtiometry (DXA) performed

once it was ascertained they qualified for this substudy. The hand

x-rays (analyzed using the Sharp method[2]) that were done closest to

the time of the DXA study were used for comparison with the BMD

measurements in cross-sectional analysis.

*******************************************************

Read the entire article here:

http://www.medscape.com/viewarticle/713717

Not an MD