Bone losses in patients with rheumatoid arthritis (RA) include focal marginal joint erosion, juxtaarticular osteopenia, and systemic osteoporosis. Systemic osteoporosis prevalent in RA is associated with increased fracture rates and is a cause of very high morbidity and mortality. A couple of reports showed that advanced glycation end-products (AGEs) influence osteoclasts (bone resorption) and osteoblasts (bone formation), so AGEs may be have an important role in the pathogenesis of osteoporotic bone diseases. Recently, it was demonstrated that AGEs is increased in patients with RA and the concentration of AGEs correlates with the disease activity of RA. We present a hypothesis that AGEs may be involved in the pathogenesis of osteoporosis in patients with RA and the AGE crosslink breaker alagebrium will be a powerful therapeutic agent for osteoporosis in patients with RA.
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