Management of Osteoporosis in Inflammatory Rheumatic Diseases

Inflammatory rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, systemic sclerosis and other systemic inflammatory diseases are associated with an increased risk of comorbid osteoporosis and osteoporotic fractures. High disease activity, reduced mobility and systemic glucocorticoid treatment are significant risk factors increasing the risk of fractures additionally to the background fracture risk. Therefore an early inhibition of inflammatory activity aiming at the remission of disease activity is essential. Evaluation of disease activity in patients with rheumatic diseases should include early assessment of osteoporosis so that inflammation-induced osteoporosis can be detected early and the risk of osteoporotic fractures can additionally be reduced with specific antiosteoporotic medications. Existing guidelines offer sufficient guidance to achieve this in the outpatient and inpatient care of these patients.