Evaluating and mitigating fracture risk in established rheumatoid arthritis

• Published in: Best practice & research. Clinical rheumatology 2015-08, Vol.29 (4), p.614-627
• Main Authors: Mullen, Matthew B, Saag, Kenneth G
• Format: Article
• Language: English
• Subjects: Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - drug therapy; Bone Resorption - diagnosis; Bone Resorption - etiology; Bone Resorption - prevention & control; Fracture risk; Fractures, Bone - diagnosis; Fractures, Bone - etiology; Fractures, Bone - prevention & control; Glucocorticoid-induced osteoporosis; Glucocorticoids - therapeutic use; Humans; Life Style; Osteoporosis; Osteoporosis - diagnosis; Osteoporosis - etiology; Osteoporosis - prevention & control; Rheumatoid arthritis; Rheumatology; Risk Assessment
• ISSN: 1521-6942; 1532-1770
• DOI: 10.1016/j.berh.2015.09.005

Abstract Patients with rheumatoid arthritis are predisposed to systemic bone loss, and they are at an increased risk of fractures. Although there are similarities in the patient demographics between rheumatoid arthritis patients and the general population of osteoporosis patients, there are factors, particularly the use of glucocorticoids, which are specific to rheumatoid arthritis. These factors can lead to an increased risk of bone loss and fracture. Given that fractures are often very debilitating, especially in elderly patients, it is of paramount importance for the practicing rheumatologist to be aware of ways to reduce the risk of fracture in patients with rheumatoid arthritis. This review discusses currently available modalities for fracture risk assessment as well as pharmacologic and lifestyle interventions available to treat and prevent bone loss in rheumatoid arthritis patients.