2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6f3,Osteoporosis causes fractures that further increase the disease burden of rheumatoid arthritis (RA); however, osteoporosis treatment rates remain low. Although several studies have reported that biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) can prevent or improve osteoporosis in RA, our large-scale, real-world study showed that one-year b/tsDMARDs use did not arrest osteoporosis progression. This study aimed to examine longer-term changes in bone mineral density (BMD). BMD was observed for up to five years in patients receiving b/tsDMARDs for active RA. The primary endpoint was change in BMD (T score), and the secondary endpoint was change in T score-related factors. In total, 797 patients (antiosteoporosis-, n = 645; antiosteoporosis+, n = 152) were included, with a median 3.1-year follow-up (2,489 patient-years). Clinical Disease Activity Index (CDAI) improved in both groups (antiosteoporosis- 26.0 to 6.6; antiosteoporosis+ 24.4 to 6.8). T scores decreased significantly in the femoral neck and radius in the antiosteoporosis- group but not in the antiosteoporosis+ group (antiosteoporosis-: mean change -0.11 to -0.33, both P < 0.001; antiosteoporosis+ -0.01 to -0.10, P = 0.830 and 0.071, respectively). Overall, 460 patients (58%) experienced a decrease in T score. A high baseline T score correlated with a subsequent decrease, whereas longer osteoporosis treatment duration correlated with an increase. Unexpectedly, the duration of b/tsDMARD use and mean CDAI during observation were not associated with BMD maintenance. Even when RA activity was controlled with b/tsDMARDs, BMD still decreased. This study emphasizes the importance of considering osteoporosis as an independent aspect of RA, beyond inflammation control.31:Tbfd, Objective Osteoporosis causes fractures that further increase the disease burden of rheumatoid arthritis (RA); however, osteoporosis treatment rates remain low. Although several studies have reported that biologic or targeted synthetic disease‐modifying antirheumatic drugs (b/tsDMARDs) can prevent or improve osteoporosis in RA, our large‐scale, real‐world study showed that one‐year b/tsDMARDs use did not arrest osteoporosis progression. This study aimed to examine longer‐term changes in bone mineral density (BMD). Methods BMD was observed for up to five years in patients receiving b/tsDMARDs for active RA. The primary endpoint was change in BMD (T score), and the secondary endpoint was change in T score–related factors. Results In total, 797 patients (antiosteoporosis–, n = 645; antiosteoporosis+, n = 152) were included, with a median 3.1‐year follow‐up (2,489 patient‐years). Clinical Disease Activity Index (CDAI) improved in both groups (antiosteoporosis– 26.0 to 6.6; antiosteoporosis+ 24.4 to 6.8). T scores decreased significantly in the femoral neck and radius in the antiosteoporosis− group but not in the antiosteoporosis+ group (antiosteoporosis–: mean change –0.11 to –0.33, both P < 0.001; antiosteoporosis+ –0.01 to –0.10, P = 0.830 and 0.071, respectively). Overall, 460 patients (58%) experienced a decrease in T score. A high baseline T score correlated with a subsequent decrease, whereas longer osteoporosis treatment duration correlated with an increase. Unexpectedly, the duration of b/tsDMARD use and mean CDAI during observation were not associated with BMD maintenance. Conclusion Even when RA activity was controlled with b/tsDMARDs, BMD still decreased. This study emphasizes the importance of considering osteoporosis as an independent aspect of RA, beyond inflammation control.

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Conversely, patients in lower-GDP countries started treatment with **worse disease activity**, especially in PsA. The strongest socioeconomic effects on retention were seen with GDP per capita and HDI, and were most pronounced in women with axSpA.","limitations":"- Country-level (ecological) socioeconomic indicators were used rather than individual patient-level socioeconomic data, limiting causal inference.\n- Registry data may reflect variation in prescribing practices, access policies, and drug availability across countries rather than purely socioeconomic effects.\n- The 2015–2021 timeframe may not reflect more recent changes in drug access or health policy across Europe.","practice_takeaway":"In lower-income European countries, patients with PsA and axSpA tend to start biologics with higher disease burden and stay on them longer — possibly due to restricted switching options rather than better drug performance. Clinicians and health policy makers in these settings should actively monitor disease activity at treatment initiation and ensure timely access to treatment optimization."}},{"doi":"10.1002/art.70125","pmid":"41797301","title":"Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long‐Term Multicenter Observational Study","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-03-09T00:00:00.000Z","url":"https://doi.org/10.1002/art.70125","source_score":22,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-25","doi":"10.1002/art.70125","days":"30","issn":"2326-5191","rank":"8","field":"Clinical Medicine","score":"22","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1002/art.70125","title":"Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long-Term Multicenter Observational Study.","journal":"Arthritis & rheumatology (Hoboken, N.J.)","methods":"","results":"In total, 797 patients (antiosteoporosis-, n = 645; antiosteoporosis+, n = 152) were included, with a median 3.1-year follow-up (2,489 patient-years). Clinical Disease Activity Index (CDAI) improved in both groups (antiosteoporosis- 26.0 to 6.6; antiosteoporosis+ 24.4 to 6.8). T scores decreased significantly in the femoral neck and radius in the antiosteoporosis- group but not in the antiosteoporosis+ group (antiosteoporosis-: mean change -0.11 to -0.33, both P < 0.001; antiosteoporosis+ -0.01 to -0.10, P = 0.830 and 0.071, respectively). Overall, 460 patients (58%) experienced a decrease in T score. A high baseline T score correlated with a subsequent decrease, whereas longer osteoporosis treatment duration correlated with an increase. Unexpectedly, the duration of b/tsDMARD use and mean CDAI during observation were not associated with BMD maintenance.","abstract":"$30","keywords":[],"pubmed_id":"41797301","conclusions":"Even when RA activity was controlled with b/tsDMARDs, BMD still decreased. This study emphasizes the importance of considering osteoporosis as an independent aspect of RA, beyond inflammation control.","publication_date":"2026-03-09T00:00:00"},"crossref":{"DOI":"10.1002/art.70125","URL":"https://doi.org/10.1002/art.70125","ISSN":["2326-5191","2326-5205"],"link":[{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.70125","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/full-xml/10.1002/art.70125","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.70125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients 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Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Saiseikai Yahata General Hospital Kitakyushu Japan"}]},{"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Medical Informatics and Management Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Atsushi","family":"Nagayasu","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Infectious Disease Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Satoshi","family":"Kubo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Kyusyu Rosai Hospital Kitakyushu Japan"}]},{"given":"Ippei","family":"Miyagawa","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"},{"name":"Department of Rheumatology Kokura Memorial Hospital Kitakyushu Japan"}]},{"given":"Ayako","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Laboratory and Transfusion Medicine Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Fukuoka Shin Mizumaki Hospital Kitakyushu Japan"},{"name":"Department of Rheumatology Shin‐Kokura Hospital Kitakyushu Japan"}]},{"given":"Naoaki","family":"Ohkubo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Environmental Epidemiology University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Obase Hospital Kanda Japan"}]},{"given":"Yasuyuki","family":"Todoroki","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"},{"name":"Department of Rheumatology Steel Memorial Yawata Hospital Kitakyushu Japan"}]},{"given":"Yurie","family":"Satoh‐Kanda","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Tochiku Hospital Kitakyushu Japan"}]},{"given":"Masanobu","family":"Ueno","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Ryuichiro","family":"Kanda","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Yuya","family":"Fujita","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Ashiya Central Hospital Kitakyushu Japan"}]},{"given":"Masashi","family":"Funada","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Hidenori","family":"Sakai","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yamaguchi‐ken Saiseikai Shimonoseki General Hospital Shimonoseki Japan"}]},{"given":"Satsuki","family":"Matsunaga","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yamaguchi Rosai Hospital Sanyo‐Onoda Japan"}]},{"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Hagiwara Central Hospital Kitakyushu Japan"}]},{"given":"Masayuki","family":"Shinojima","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Kenai Memorial Hospital Kitakyushu Japan"}]},{"given":"Hiroki","family":"Kawamura","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Ohira Medical Care Hospital Kitakyushu Japan"}]},{"given":"Kazuki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Hosoe Clinic Shimonoseki Japan"}]},{"given":"Miyabi","family":"Ando","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Sasaki Hospital Kitakyushu Japan"}]},{"given":"Kazuki","family":"Haru","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yoshino Hospital Kitakyushu Japan"}]},{"given":"Yusuke","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology and Diabetology Wakamatsu Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Kentaro","family":"Hanami","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Diabetology Kitakyushu General Hospital Kitakyushu Japan"}]},{"given":"Masao","family":"Nawata","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Kokura Rheumatology Clinic Kitakyushu Japan"}]},{"given":"Shunsuke","family":"Fukuyo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology and Diabetology Wakamatsu Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Keisuke","family":"Nakatsuka","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Japan Community Health care Organization Fukuoka Yutaka Central Hospital Nogata Japan"}]},{"given":"Mikiko","family":"Tokunaga","sequence":"additional","affiliation":[{"name":"Hakataeki Minami Tokunaga Clinic Fukuoka Japan"}]},{"given":"Kazuyoshi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology Tobata General Hospital Kitakyushu Japan"}]},{"given":"Yoshiya","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"}]}],"funder":[{"id":[{"id":"10.13039/100016239","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100016239","name":"University of Occupational and Environmental 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Overall, 58% of patients (460/797) experienced a T-score decrease. Duration of b/tsDMARD use and mean CDAI were **not** associated with BMD maintenance.","limitations":"- Observational design limits causal inference; anti-osteoporosis treatment was not randomized.\n- Anti-osteoporosis therapy group was much smaller (n=152 vs. n=645), risking imbalance.\n- Fracture outcomes were not reported as an endpoint.","practice_takeaway":"Even with well-controlled RA on b/tsDMARDs, bone loss continues — clinicians should screen for and treat osteoporosis independently of inflammation management. Anti-osteoporosis therapy, not DMARD use alone, was associated with BMD preservation."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Targeted Synthetic Disease-Modifying Antirheumatic Drug"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Targeted Synthetic Disease-Modifying Antirheumatic Drug"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Targeted Synthetic Disease-Modifying Antirheumatic Drug"}}}]]

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