Abstract
Biologic agents used in the treatment of rheumatoid arthritis (RA) are able to reduce both disease activity and radiographic progression of joint disease. These drugs are directed against several proinflammatory cytokines (TNF α , IL-6, and IL-1) which are involved both in the pathogenesis of chronic inflammation and progression of joint structural damage and in systemic and local bone loss typically observed in RA. However, the role of biologic drugs in preventing bone loss in clinical practice has not yet clearly assessed. Many clinical studies showed a trend to a positive effect of biologic agents in preventing systemic bone loss observed in RA. Although the suppression of inflammation is the main goal in the treatment of RA and the anti-inflammatory effects of biologic drugs exert a positive effect on bone metabolism, the exact relationship between the prevention of bone loss and control of inflammation has not been clearly established, and if the available biologic drugs against TNF α , IL-1, and IL-6 can exert their effect on systemic and local bone loss also through a direct mechanism on bone cell metabolism is still to be clearly defined.
MeSH terms
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Anti-Inflammatory Agents / pharmacology
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Anti-Inflammatory Agents / therapeutic use
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Antirheumatic Agents / pharmacology
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Antirheumatic Agents / therapeutic use*
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Arthritis, Rheumatoid / diagnostic imaging
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Arthritis, Rheumatoid / drug therapy*
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Arthritis, Rheumatoid / immunology
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Arthritis, Rheumatoid / pathology
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Bone Resorption / diagnostic imaging
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Bone Resorption / immunology
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Bone Resorption / pathology
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Bone Resorption / prevention & control*
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Bone and Bones / drug effects*
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Bone and Bones / immunology
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Bone and Bones / pathology
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Disease Progression
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Gene Expression
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Humans
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Immunologic Factors / pharmacology
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Immunologic Factors / therapeutic use*
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Inflammation / prevention & control
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Interleukin-1 / antagonists & inhibitors
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Interleukin-1 / genetics
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Interleukin-1 / immunology
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Interleukin-6 / antagonists & inhibitors
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Interleukin-6 / genetics
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Interleukin-6 / immunology
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Joints / drug effects*
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Joints / immunology
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Joints / pathology
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Radiography
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
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Tumor Necrosis Factor-alpha / genetics
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Tumor Necrosis Factor-alpha / immunology
Substances
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Anti-Inflammatory Agents
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Antirheumatic Agents
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Immunologic Factors
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Interleukin-1
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Interleukin-6
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Tumor Necrosis Factor-alpha