Michail I Krikelis, Dimitra Moschou, Konstantina Zoupidou, Evangelia Mole, Konstantinos Makris, Simeon Tournis, Sousana Gazi, Vassilios Nikolaou, Clio Mavragani, Efstathios Chronopoulos
Aberrant bone loss and impaired bone formation are hallmarks of rheumatoid arthritis. The underlying pathophysiological mechanisms differ between early and refractory disease, suggesting a potential central role of the highly conserved Wnt pathway in the bone impairment observed in established RA.
INTRODUCTION AND METHODS: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterised by bone loss. A Medline/PubMed search was conducted in September 2025 using the keywords "rheumatoid arthritis" AND "bone loss." The search was restricted to recently published review or systematic review articles (2020-2025). In total, 24 articles were thoroughly reviewed.
RESULTS: Inflammation-induced accelerated bone resorption both at the systemic level and in juxta-articular bone is typical to rheumatoid arthritis. Bone formation and bone biomechanics are also impaired due to inflammation, prolonged or repeated corticosteroid treatment, and muscle wasting.
CONCLUSIONS: Aberrant bone loss and impaired bone formation are hallmarks of rheumatoid arthritis. The underlying pathophysiological mechanisms differ between early and refractory disease, suggesting a potential central role of the highly conserved Wnt pathway in the bone impairment observed in established RA.