Effects of targeted therapies on the bone in arthritides

Ágnes Szentpétery, Ágnes Horváth, Katalin Gulyás, Zsófia Pethö, Harjit Pal Bhattoa, S. Szántó, G. Szűcs, Oliver FitzGerald, Georg Schett, Zoltán Szekanecz

Research output: Contribution to journalReview article

22 Citations (Scopus)


Inflammatory arthritides, such as rheumatoid arthritis (RA) and spondyloarthritides (SpA) have been associated with both localized bone resorption and/or formation, and generalized osteoporosis. Systemic inflammation may be the major driver for bone loss in arthritis. In RA and peripheral SpA the RANK-RANKL-OPG network is involved in bone resorption, while in axial SpA the Wnt-β-catenin axis and its inhibitors (DKK-1, sclerostin) are the most relevant. Targeted therapies including biologics and small molecule tyrosine kinase inhibitors may interfere with inflammatory bone metabolism. Most of these compounds are able to slow down radiographic progression and osteoporosis in arthritides. In very early cases of non-radiological SpA, there may be a window of opportunity allowing to prevent syndesmophyte formation. The inability of targeted therapies to increase the production of DKK-1 and sclerostin may explain the lack of efficacy of TNF inhibitors to halt syndesmophyte formation in SpA. Further clinical trials are needed to better understand the bone effects of targeted therapies.

Original languageEnglish
Pages (from-to)313-320
Number of pages8
JournalAutoimmunity Reviews
Issue number3
Publication statusPublished - Mar 1 2017


  • Biologics
  • Bone loss
  • DKK-1
  • Erosion
  • JAK inhibitors
  • Osteoporosis
  • Osteoprotegerin
  • Rheumatoid arthritis
  • Sclerostin
  • Spondyloarthritis
  • Syndesmophyte

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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    Szentpétery, Á., Horváth, Á., Gulyás, K., Pethö, Z., Bhattoa, H. P., Szántó, S., Szűcs, G., FitzGerald, O., Schett, G., & Szekanecz, Z. (2017). Effects of targeted therapies on the bone in arthritides. Autoimmunity Reviews, 16(3), 313-320. https://doi.org/10.1016/j.autrev.2017.01.014