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

To investigate the long-term effects of biologic and targeted synthetic DMARDs on bone metabolism in patients with rheumatoid arthritis.

Approach:
  • Study Design: A multicenter prospective observational study was conducted as part of the FIRST registry, enrolling patients with active RA initiating their first b/tsDMARD from August 2013 to July 2022.
  • Participants: Consecutive patients fulfilling the 2010 RA classification criteria were included. Participants provided informed consent and were followed for up to five years.
  • BMD Measurement: Bone mineral density (BMD) was measured at the femoral neck and one-third radius at specified intervals, with assessments conducted at the Hospital of the University of Occupational and Environmental Health.
Key Findings:
  • Despite treatment with b/tsDMARDs, bone mineral density at the femoral neck and radius decreased significantly over five years.
  • The study included 1,164 patients with active RA, showing marked disease activity decline but no improvement in systemic osteoporosis.
  • Treatment rates for osteoporosis remain low among RA patients, particularly those using glucocorticoids.
Interpretation:

The findings suggest that b/tsDMARD therapy and inflammation control may not be sufficient to manage osteoporosis in RA patients.

Limitations:
  • The study did not assess lumbar spine BMD due to potential overestimation from degenerative disease.
  • Censored cases were handled for participants who did not attend annual assessments.
Conclusion:

The study emphasizes the need for ongoing attention to bone health in RA patients, as treatment with b/tsDMARDs alone does not halt osteoporosis progression.

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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