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Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 945945, 7 pages
http://dx.doi.org/10.1155/2013/945945
Review Article

Bone Effects of Biologic Drugs in Rheumatoid Arthritis

Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Ospedale “Col. D’Avanzo”, Viale degli Aviatori, 71100 Foggia, Italy

Received 3 April 2013; Accepted 2 June 2013

Academic Editor: Giorgio Mori

Copyright © 2013 Addolorata Corrado et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 (TNFα, 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 TNFα, 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.