Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long-Term Multicenter Observational Study - Report - MDSpire
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Long-Term Multicenter Observational Study Reveals No Impact of Biologic and Targeted Synthetic DMARDs on Bone Loss in Rheumatoid Arthritis Patients

  • By

  • Takafumi Aritomi

  • Koshiro Sonomoto

  • Shingo Nakayamada

  • Hiroaki Tanaka

  • Atsushi Nagayasu

  • Satoshi Kubo

  • Ippei Miyagawa

  • Ayako Yamaguchi

  • Naoaki Ohkubo

  • Yasuyuki Todoroki

  • Yurie Satoh-Kanda

  • Masanobu Ueno

  • Ryuichiro Kanda

  • Yuya Fujita

  • Masashi Funada

  • Hidenori Sakai

  • Satsuki Matsunaga

  • Masayuki Shinojima

  • Hiroki Kawamura

  • Kazuki Takahashi

  • Miyabi Ando

  • Kazuki Haru

  • Yusuke Miyazaki

  • Kentaro Hanami

  • Masao Nawata

  • Shunsuke Fukuyo

  • Keisuke Nakatsuka

  • Mikiko Tokunaga

  • Kazuyoshi Saito

  • Yoshiya Tanaka

  • April 21, 2026

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Clinical Report: Long-Term Multicenter Observational Study Reveals No Impact of Biologic and Targeted Synthetic DMARDs on Bone Loss in Rheumatoid Arthritis Patients

Overview

This study investigates the long-term effects of biologic and targeted synthetic DMARDs on bone metabolism in rheumatoid arthritis (RA) patients, including a cohort of 1,164 patients. Findings indicate that despite a decrease in disease activity, these treatments do not prevent bone mineral density loss over five years.

Background

Rheumatoid arthritis is associated with systemic osteoporosis, which significantly impacts patient health and quality of life. The management of osteoporosis in RA is critical, especially as treatment rates remain low among patients at high risk due to glucocorticoid use. Understanding the role of b/tsDMARDs in bone health is essential for optimizing patient care.

Data Highlights

No significant improvement in bone mineral density was observed in RA patients treated with b/tsDMARDs over five years, despite reduced disease activity.

Key Findings

  • Bone mineral density at the femoral neck and radius decreased significantly in patients receiving b/tsDMARDs.
  • Only 38% to 60% of glucocorticoid users with RA receive osteoporosis treatment.
  • Remission in RA is associated with reduced osteoporosis risk.
  • Long-term outcomes of b/tsDMARDs on bone metabolism remain uncertain.
  • Osteoporosis management in RA is critical as treatment rates are suboptimal.

Clinical Implications

Rheumatologists should remain vigilant about osteoporosis management in RA patients, particularly those on glucocorticoids.

Conclusion

The study highlights the need for ongoing attention to osteoporosis management in RA, as b/tsDMARDs alone do not prevent bone loss.

Related Resources & Content

  1. Aritomi, H., Arthritis & Rheumatology, 2026 -- Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long‐Term Multicenter Observational Study
  2. Drug Safety, 2026 -- Safety of Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis: A Longitudinal Analysis
  3. Clinical Rheumatology, 2026 -- Lower odds of prevalent vertebral fractures with b/tsDMARD use among rheumatoid arthritis patients in clinical remission: a retrospective observational study
  4. MDSpire News, 2026 -- Trial Exclusions May Skew RA Drug Comparisons
  5. Recommendations Management | EULAR, 2026 -- EULAR recommendations for rheumatoid arthritis pharmacologic management
  6. Clinical Rheumatology — Impact of One Year of Anti-TNF-α Treatment on Bone Mineral Density and Biomarkers in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis
  7. Recommendations Management | EULAR
  8. Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long‐Term Multicenter Observational Study - Aritomi - Arthritis & Rheumatology - Wiley Online Library
  9. Changes in bone mineral density and fractures during 2 years of low-dose glucocorticoid treatment for rheumatoid arthritis: a systematic literature review and individual participant data meta-analysis

Original Source(s)

Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long-Term Multicenter Observational Study

  • by Takafumi Aritomi, Koshiro Sonomoto, Shingo Nakayamada, Hiroaki Tanaka, Atsushi Nagayasu, Satoshi Kubo, Ippei Miyagawa, Ayako Yamaguchi, Naoaki Ohkubo, Yasuyuki Todoroki, Yurie Satoh-Kanda, Masanobu Ueno, Ryuichiro Kanda, Yuya Fujita, Masashi Funada, Hidenori Sakai, Satsuki Matsunaga, Masayuki Shinojima, Hiroki Kawamura, Kazuki Takahashi, Miyabi Ando, Kazuki Haru, Yusuke Miyazaki, Kentaro Hanami, Masao Nawata, Shunsuke Fukuyo, Keisuke Nakatsuka, Mikiko Tokunaga, Kazuyoshi Saito, Yoshiya Tanaka

  • April 21, 2026

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