Bone metabolism in rheumatoid arthritis

In active RA, bone resorption is increased and bone formation is normal or reduced in comparison to healthy controls. This uncoupling of bone formatio n and resorption with a negative remodelling balance lends to generalized b one loss. The pathogenesis of this altered bone metabolism is multifactorial, involvi ng non-disease-specific factors (such as age, female sex and postmenopausal status) and disease-specific factors. Disease-specific factors are associa ted with disease activity (inflammatory cells and cytokines; hypogonadism), disease outcome (especially reduced mobility), and disease medication (e.g . corticosteroids).