Abstract

Inflammatory diseases and bone fragility

Briot K1,2,3, Geusens P4,5, Em Bultink I6, Lems WF6, Roux C7,8,9,10. Osteoporos Int. 2017 Sep 15. doi: 10.1007/s00198-017-4189-7. [Epub ahead of print]
 
     
Author information

1 Department of Rheumatology, Cochin Hospital, Assistance-Publique-Hôpitaux de Paris, Paris, France. karine.briot@aphp.fr. 2 Hôpital Cochin, Service de Rhumatologie, 27, Rue du Faubourg, St. Jacques, 75014, Paris, France. karine.briot@aphp.fr. 3 INSERM UMR 1153, Paris, France. karine.briot@aphp.fr. 4 Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands. 5 Hasselt University, Hasselt, Belgium. 6 Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands. 7 Department of Rheumatology, Cochin Hospital, Assistance-Publique-Hôpitaux de Paris, Paris, France. 8 Hôpital Cochin, Service de Rhumatologie, 27, Rue du Faubourg, St. Jacques, 75014, Paris, France. 9 INSERM UMR 1153, Paris, France. 10 Paris Descartes University, Paris, France.

Abstract

Systemic osteoporosis and increased fracture rates have been described in chronic inflammatory diseases such as rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, inflammatory bowel diseases, and chronic obstructive pulmonary disease. Most of these patients receive glucocorticoids, which have their own deleterious effects on bone. However, the other main determinant of bone fragility is the inflammation itself, as shown by the interactions between the inflammatory mediators, the actors of the immune system, and the bone remodelling. The inflammatory disease activity is thus on top of the other well-known osteoporotic risk factors in these patients. Optimal control of inflammation is part of the prevention of osteoporosis, and potent anti-inflammatory drugs have positive effects on surrogate markers of bone fragility. More data are needed to assess the anti-fracture efficacy of a tight control of inflammation in patients with a chronic inflammatory disorder. This review aimed at presenting different clinical aspects of inflammatory diseases which illustrate the relationships between inflammation and bone fragility.

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