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Rheumatoid arthritis and bone health


Clin Med (Lond). 2020 Nov;20(6):565-567. doi: 10.7861/clinmed.20.6.rabh.

Shanze Ashai 1Nicholas C Harvey 2

Author Information

1 MRC Lifecourse Epidemiology Unit, Southampton, UK.

2 MRC Lifecourse Epidemiology Unit, Southampton, UK nch@mrc.soton.ac.uk.


Rheumatoid arthritis (RA) is an inflammatory arthropathy affecting 1% of the population, with a female predominance. Systemic inflammation is a key component of RA disease; corticosteroids are often required to rapidly control disease activity. Both inflammation and corticosteroids, however, have an adverse effect on bone mineral density, potentially resulting in osteoporosis and an increased risk of fractures. In this article, we describe the link between RA and impaired bone health, together with appropriate strategies to maintain bone density and reduce fracture risk. Key approaches include achieving adequate control of inflammation, minimising corticosteroid use, monitoring bone mineral density and intervening with antiosteoporosis medications when indicated.