Остеопороз при ревматических заболеваниях

Представлен обзор исследований, в которых изучался остеопороз при ревматических заболеваниях, включая ревматоидный артрит, спондилоартрит, псориатический артрит, системные заболевания соединительной ткани и системные васкулиты. В обзоре освещены вопросы патогенеза, диагностики и лечения остеопороза при данных заболеваниях, представлены результаты эпидемиологических исследований, оценивающих факторы риска и распространенность остеопороза при ревматических заболеваниях. Отмечена высокая распространенность остеопороза и переломов при ревматических заболеваниях, превышающая популяционную, связанная прежде всего с системным и локальным воспалением, а также с приемом глюкокортикоидов. Указано, что существующие стратегии лечения ревматических заболеваний, направленные на подавление воспаления, в какой-то степени тормозят резорбцию костной ткани, но длительный прием глюкокортикоидов, напротив, усиливает ее. В обзоре представлены данные об основных препаратах для лечения остеопороза и подходы к лечению глюкокортикоидного остеопороза.

1. Галушко Е. А., Насонов Е. Л. Распространенность ревматических заболеваний в России. Альманах клинической медицины. 2018; 46 (1): 32–9.

2. Гордеев А. В., Галушко Е. А., Насонов Е. Л. Концепция мультиморбидности в ревматологической практике. Научно-практическая ревматология. 2014; 52 (4): 362–365.

3. Ziade N., El Khoury B., Zoghbi M. et. al. Prevalence and pattern of comorbidities in chronic rheumatic and musculoskeletal diseases: the COMORD study. Sci Rep. 2020 May 6;10 (1): 7683.

4. Smith E., Hoy D. G., Cross M.et. al. The global burden of other musculoskeletal disorders: Estimates from the Global Burden of Disease 2010 study. Ann. Rheum. Dis. 2014; 73: 1462–1469.

5. Adami G, Fassio A, Rossini M. et. al. Osteoporosis in Rheumatic Diseases. Int J Mol Sci. 2019 Nov 22; 20 (23): 5867.

6. Баранова И. А. Глюкокортикоидиндуцированный остеопороз: патогенез, профилактика, лечение. Современная ревматология. 2008; 2: 31–39.

7. Баранова И. А., Ершова О. Б., Анаев Э. Х. и др. Оценка частоты и факторов риска низкоэнергетических переломов скелета по данным опроса вольных хроническими воспалительными заболеваниями. Результаты многоцентрового исследования российской ассоциации по остеопорозу ГЛЮКОСТ. Остеопороз и остеопатии. 2014; 17 (3): 9–14.

8. Гладкова Е. Н., Кожемякина Е. В., Евстигнеева Л. П. и др. Остеопороз и ассоциированные с ним переломы у пациентов старшего возраста с воспалительными ревматическими заболеваниями. Остеопороз и остеопатии, 2015, 2 (9–14).

9. Добровольская О. В., Ефремова А. О., Демин Н. В., Торопцова Н. В. Минеральная плотность костной ткани и риск переломов у больных ревматическими заболеваниями. Медицинский совет. 2020; (8): 120–127.

10. Добровольская О. В., Демин Н. В., Смирнов А. В. и др. Минеральная плотность костной ткани у женщин репродуктивного возраста с ревматическими заболеваниями. Медицинский алфавит. Серия «Ревматология в общей врачебной практике». 2019. Т. 2. 37 (412). С. 7–11.

11. McInnes I.B., Schett G. The Pathogenesis of Rheumatoid Arthritis. New Engl. J. Med. 2011; 365: 2205–2219.

12. Adami G., Saag K.G. Osteoporosis Pathophysiology, Epidemiology, and Screening in Rheumatoid Arthritis. Curr. Rheumatol. Rep. 2019; 21: 34.

13. Kleyer A., Finzel S., Rech J. et al. Bone Loss Before the Clinical Onset of Rheumatoid Arthritis in Subjects with Anticitrullinated Protein Antibodies. Ann. Rheum. Dis. 2014; 73: 854–860.

14. Haugeberg G., Helgetveit K. B., Forre O.et. al. Generalized Bone Loss in Early Rheumatoid Arthritis Patients Followed for Ten Years in the Biologic Treatment Era. BMC Musculoskelet. Disord. 2014; 15: 289.

15. Zhu T. Y., Griffth J. F., Qin L. et al. Alterations of Bone Density, Microstructure, and Strength of the Distal Radius in Male Patients with Rheumatoid Arthritis: A Case-Control Study with HR-pQCT. J. Bone Miner. Res. 2014; 29: 2118–2129.

16. Simon D., Kleyer A., Stemmler F. et al. Age- And Sex-Dependent Changes of Intra-Articular Cortical and Trabecular Bone Structure and the Effects of Rheumatoid Arthritis. J. Bone Miner. Res. 2017; 32: 722–730.

17. Stemmler F., Simon D., Liphardt A. M. et. al. Biomechanical Properties of Bone are Impaired in Patients with ACPA-Positive Rheumatoid Arthritis and Associated with the Occurrence of Fractures. Ann. Rheum. Dis. 2018; 77: 973–980.

18. Rotta D, Fassio A, Rossini M. et. al. Osteoporosis in Inflammatory Arthritides: New Perspective on Pathogenesis and Treatment. Front Med (Lausanne). 2020 Dec 1; 7: 613–720.

19. Takayanagi H. New Developments in Osteoimmunology. Nat. Rev. Rheumatol. 2012; 8: 684–689.

20. Fessler J., Husic R., Schwetz V. et al. Senescent T-Cells Promote Bone Loss in Rheumatoid Arthritis. Front. Immunol. 2018; 9: 95.

21. Hauser B, Riches PL, Gilchrist T. et. al. Autoantibodies to osteoprotegerin are associated with increased bone resorption in rheumatoid arthritis. Ann Rheum Dis. 2015 Aug; 74 (8): 1631–2.

22. Ma Y., Zhang X., Wang M. et al. The Serum Level of Dickkopf-1 in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Int. Immunopharmacol. 2018; 59: 227–232.

23. Rossini M., Viapiana O., Adami S.et. al. In Patients with Rheumatoid Arthritis, Dickkopf-1 Serum Levels are Correlated with Parathyroid Hormone, Bone Erosions and Bone Mineral Density. Clin. Exp. Rheumatol. 2015; 33: 77–83.

24. Diarra D., Stolina M., Polzer K. et al. Dickkopf-1 is a Master Regulator of Joint Remodeling. Nat. Med. 2007; 13: 156–163.

25. Viapiana O., Fracassi E., Troplini S.et. al. Sclerostin and DKK1 in Primary Hyperparathyroidism. Calcif. Tissue Int. 2013; 92: 324–329.

26. Adami G., Rossini M., Bogliolo L. et al. An Exploratory Study on the Role of Vitamin D Supplementation in Improving Pain and Disease Activity in Rheumatoid Arthritis. Mod. Rheumatol. 2018; 29: 1059–1062.

27. Brance M. L., Brun L. R., Lioi S. et. al. Vitamin D Levels and Bone Mass in Rheumatoid Arthritis. Rheumatol. Int. 2015; 35: 499–505.

28. Kocijan R., Harre U., Schett G. ACPA and Bone Loss in Rheumatoid Arthritis. Curr. Rheumatol. Rep. 2013; 15: 366.

29. Orsolini G., Viapiana O., Rossini M.et. al. Anti-CCP Antibodies and Bone. Arthritis Res. Ther. 2018; 20: 63.

30. Orsolini G., Caimmi C., Viapiana O.et. al. Titer-Dependent Effect of Anti-Citrullinated Protein Antibodies on Systemic Bone Mass in Rheumatoid Arthritis Patients. Calcif. Tissue Int. 2017; 101: 17–23.

31. Bugatti S., Bogliolo L., Vitolo B. et. al. Anti-Citrullinated Protein Antibodies and High Levels of Rheumatoid Factor are Associated with Systemic Bone Loss in Patients with Early Untreated Rheumatoid Arthritis. Arthritis Res. Ther. 2016; 18: 226.

32. Simon D., Kleyer A., Englbrecht M. et al. A Comparative Analysis of Articular Bone in Large Cohort of Patients with Chronic Inflammatory Diseases of the Joints, the Gut and the skin. Bone. 2018; 116: 87–93.

33. Мясоедова С. Е., Рубцова О. А., Мясоедова Е. Е. Композиционный состав тела и минеральная плотность кости у женщин при ревматоидном артрите. Клиницист, 2016, т. 10, № 3: 41–45.

34. Добровольская О. В., Феклистов А. Ю., Ефремова А. О. и др. Остеопороз и саркопения у женщин с ревматоидным артритом. Современная ревматология. 2020; 14 (2): 84–89.

35. Haugeberg G., Uhlig T., Falch J. A.et. al. Bone Mineral Density and Frequency of Osteoporosis in Female Patients with Rheumatoid Arthritis: Results from 394 Patients in the Oslo County Rheumatoid Arthritis Register. Arthritis Rheum. 2000; 43: 522–530.

36. Sinigaglia L., Nervetti A., Mela Q. et al. A multicenter Cross-Sectional Study on Bone Mineral Density in Rheumatoid Arthritis. Italian Study Group on Bone Mass in Rheumatoid Arthritis. J. Rheumatol. 2000; 27: 2582–2589.

37. Hauser B., Riches P. L., Wilson J. F. et al. Prevalence and Clinical Prediction of Osteoporosis in a Contemporary Cohort of Patients with Rheumatoid Arthritis. Rheumatology. 2014; 53: 1759–1766.

38. Mori Y., Kuwahara Y., Chiba S. et. al. Bone Mineral Density of Postmenopausal Women with Rheumatoid Arthritis Depends on Disease Duration Regardless of Treatment. J. Bone Miner. Metab. 2017; 35: 52–57.

39. Kweon SM, Sohn DH, Park JH et. al. Male patients with rheumatoid arthritis have an increased risk of osteoporosis: Frequency and risk factors. Medicine (Baltimore). 2018 Jun; 97 (24): e11122.

40. Jin S., Hsieh E., Peng L. et. al. Incidence of Fractures Among Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Osteoporos. Int. 2018; 29: 1263–1275.

41. Xue A. L., Wu S. Y., Jiang L et. al. Bone Fracture Risk in Patients with Rheumatoid Arthritis: A Meta-Analysis. Medicine. 2017; 96: e6983.

42. Chen B., Cheng G., Wang H., Feng Y. Increased Risk of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Meta-Analysis. Medicine. 2016; 95: e5262.

43. Fassio A., Idolazzi L., Jaber M.A. et. al. The negative bone Effects of the Disease and of Chronic Corticosteroid Treatment in Premenopausal Women Affected by Rheumatoid Arthritis. Reumatismo. 2016; 68: 65–71.

44. Никитинская О. А., Торопцова Н. В., Насонов Е. Л. Возможности использования калькулятора 10-летней вероятности переломов FRAX® у больных ревматоидным артритом. Научно-практическая ревматология. 2019; 57 (3): 284–288.

45. Никитинская О. А., Торопцова Н. В., Демин Н. В. и др. Риск остеопоротических переломов у больных ревматоидным артритом: результаты программы «Остеоскрининг Россия». Научно-практическая ревматология. 2018; 56 (3): 310–315.

46. Dougados M., Soubrier M., Antunez A. et al. Prevalence of Comorbidities in Rheumatoid Arthritis and Evaluation of Their Monitoring: Results of an International, Cross-Sectional Study (COMORA) Ann. Rheum. Dis. 2014; 73: 62–68.

47. Richards J.S., Cannon G.W., Hayden C.L. et al. Adherence with Bisphosphonate Therapy in US Veterans with Rheumatoid Arthritis. Arthritis Care Res. 2012; 64: 1864–1870.

48. Ozen G., Kamen D.L., Mikuls T.R. et. al. Trends and Determinants of Osteoporosis Treatment and Screening in patients with Rheumatoid Arthritis Compared to Osteoarthritis. Arthritis Care Res. 2018; 70: 713–723.

49. Chatzidionysiou K., Emamikia S., Nam J. et al. Effcacy of Glucocorticoids, Conventional and Targeted Synthetic Disease-Modifying Antirheumatic Drugs: A Systematic Literature Review Informing the 2016 Update of the EULAR Recommendations for the Management of Rheumatoid Arthritis. Ann. Rheum. Dis. 2017; 76: 1102–1107.

50. Насонов Е. Л., Каратеев Д. Е. Ревматоидный артрит. Российские клинические рекомендации. Под редакцией Е. Л. Насонова. М.: ГЭОТАР-Медиа, 2017. 17–57.

51. Дыдыкина И.С., Торопцова Н.В., Никитинская О.А. Остеопороз (первичный и глюкокортикоидный). Под редакцией Е.Л. Насонова. М.: ГЭОТАР-Медиа, 2017. 274–289.

52. Balasubramanian A., Wade S. W., Adler R. A. et. al. Glucocorticoid Exposure and Fracture Risk in a Cohort of US Patients with Selected Conditions. J. Bone Miner. Res. 2018; 33: 1881–1888.

53. Siu S., Haraoui B., Bissonnette R. et al. Meta-Analysis of Tumor Necrosis Factor Inhibitors and Glucocorticoids on Bone Density in Rheumatoid Arthritis and Ankylosing Spondylitis Trials. Arthritis Care Res. 2015; 67: 754–764.

54. Blavnsfeldt A. B.G., De Thurah A., Thomsen M. D. et. al. The Effect of Glucocorticoids on Bone Mineral Density in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials. Bone. 2018; 114: 172–180.

55. Ozen G, Pedro S, Wolfe F, Michaud K. Medications associated with fracture risk in patients with rheumatoid arthritis. Ann Rheum Dis. 2019 Aug; 78 (8): 1041–1047.

56. Клинические рекомендации «Остеопороз». [Электронный ресурс].– URL: https://www.endocrincentr.ru (дата обращения: 28.05.2021).

57. Barreira S.C., Fonseca J.E. The Impact of Conventional and Biological Disease Modifying Antirheumatic Drugs on Bone Biology. Rheumatoid Arthritis as a Case Study. Clin. Rev. Allergy Immunol. 2016; 51: 100–109.

58. Orsolini G., Fassio A., Rossini M. et. al. Effects of Biological and Targeted Synthetic DMARDs on Bone Loss in Rheumatoid Arthritis. Pharmacol. Res. 2019; 147: 104354.

59. Zerbini C. A.F., Clark P., Mendez-Sanchez L. et al. Biologic Therapies and Bone Loss in Rheumatoid Arthritis. Osteoporos. Int. 2017; 28: 429–446.

60. Adami G., Orsolini G., Adami S.et. al. Effects of TNF Inhibitors on Parathyroid Hormone and Wnt Signaling Antagonists in Rheumatoid Arthritis. Calcif. Tissue Int. 2016; 99: 360–364.

61. Fassio A., Adami G., Gatti D.et. al. Inhibition of Tumor Necrosis Factor-Alpha (TNF-alpha) in Patients with Early Rheumatoid Arthritis Results in Acute Changes of Bone Modulators. Int. Immunopharmacol. 2018; 67: 487–489.

62. Tada M., Inui K., Sugioka Y. et. al. Abatacept Might Increase Bone Mineral Density at Femoral Neck for Patients with Rheumatoid Arthritis in Clinical Practice: Airtight Study. Rheumatol. Int. 2018; 38: 777–784.

63. Chen Y.M., Chen H.H., Huang W.N. et al. Tocilizumab Potentially Prevents Bone Loss in Patients with Anticitrullinated Protein Antibody-Positive Rheumatoid Arthritis. PLoSONE. 2017; 12: e0188454.

64. Wheater G., Elshahaly M., Naraghi K. et. al. Changes in Bone Density and Bone Turnover in Patients with Rheumatoid Arthritis Treated with Rituximab, Results from an Exploratory, Prospective Study. PLoSONE. 2018; 13: e0201527.

65. Saag K. G., Emkey R., Schnitzer T. J. et al. Alendronate for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Glucocorticoid-Induced Osteoporosis Intervention Study Group. N. Engl. J. Med. 1998; 339: 292–299.

66. Reid D. M., Devogelaer J. P., Saag K. et al. Zoledronic Acid and Risedronate in the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis (HORIZON): A Multicentre, Double-Blind, Double-Dummy, Randomised Controlled Trial. Lancet. 2009; 373: 1253–1263.

67. Cohen S., Levy R.M., Keller M. et al. Risedronate Therapy Prevents Corticosteroid-Induced Bone Loss: A Twelve-Month, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study. Arthritis Rheum. 1999; 42: 2309–2318.

68. Ringe J. D., Dorst A., Faber H.et. al. Intermittent Intravenous Ibandronate Injections Reduce Vertebral Fracture Risk in Corticosteroid-Induced Osteoporosis: Results from a Long-Term Comparative Study. Osteoporos. Int. 2003; 14: 801–807.

69. Jarrett S. J., Conaghan P. G., Sloan V. S. et. al. Preliminary Evidence for a Structural Beneft of the New Bisphosphonate Zoledronic Acid in Early Rheumatoid Arthritis. Arthritis Rheum. 2006; 54: 1410–1414.

70. Saag K. G., Wagman R. B., Geusens P. et. al. Denosumab Versus Risedronate in Glucocorticoid-Induced Osteoporosis: A Multicentre, Randomised, Double-Blind, Active-Controlled, Double-Dummy, Non-Inferiority Study. Lancet Diabetes Endocrinol. 2018; 6: 445–454.

71. Банщикова Н. Е., Летягина Е. А., Омельченко В. О., Королев М. А. Антирезорбтивная активность деносумаба при лечении остеопороза у больных с ревматоидным артритом. Остеопороз и остеопатии. 2018. Т. 21. № 2. С. 4–11.

72. Добровольская О. В., Коваленко П. С., Торопцова Н.В. и др. Сравнительная оценка эффективности деносумаба у больных ревматоидным артритом и постменопаузальным остеопорозом: результаты 1-годичного исследования в клинической практике. Научно-практическая ревматология. 2019; 57 (2): 160–165.

73. Zebaze R., Libanati C., McClung M.R.et. al. Denosumab Reduces Cortical Porosity of the Proximal Femoral Shaft in Postmenopausal Women with Osteoporosis. J. Bone Miner. Res. 2016; 31: 1827–1834.

74. Sharp J. T., Tsuji W., Ory P.et. al.Denosumab Prevents Metacarpal Shaft Cortical Bone Loss in Patients with Erosive Rheumatoid Arthritis. Arthritis Care Res. 2010; 62: 537–544.

75. Cohen S. B., Dore R. K., Lane N. E. et al. Denosumab Treatment Effects on Structural Damage, Bone Mineral Density, and Bone Turnover in Rheumatoid Arthritis: A Twelve-Month, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase II Clinical Trial. Arthritis Rheum. 2008; 58: 1299–1309.

76. Takeuchi T., Tanaka Y., Ishiguro N. et. al. Effect of Denosumab on Japanese Patients with Rheumatoid Arthritis: A Dose-Response Study of AMG 162 (Denosumab) in Patients with Rheumatoid Arthritis on Methotrexate to Validate Inhibitory Effect on Bone Erosion (DRIVE)-a 12-Month, Multicentre, Randomised, Double-Blind, Placebo-Controlled, Phase II Clinical Trial. Ann. Rheum. Dis. 2016; 75: 983–990.

77. Ebina K., Hirao M., Hashimoto J. et. al. Impact of Switching Oral Bisphosphonates to Denosumab or Daily Teriparatide on the Progression of Radiographic Joint Destruction in Patients with Biologic-Naive Rheumatoid Arthritis. Osteoporos. Int. 2018; 29: 1627–1636.

78. Дыдыкина И. С., Коваленко П. С., Смирнов А. В. и др. Опыт применения деносумаба в терапии остеопороза у больных ревматоидным артритом, получающих глюкокортикоиды. Современная ревматология. 2018; 12 (2): 50–57.

79. Solomon D. H., Kay J., Duryea J. et al. Effects of Teriparatide on Joint Erosions in Rheumatoid rthritis: A Randomized Controlled Trial. Arthritis Rheumatol. 2017; 69: 1741–1750.

80. Saag K. G., Shane E., Boonen S. et. al. Teriparatide or Alendronate in Glucocorticoid-Induced Osteoporosis. New Engl. J. Med. 2007; 357: 2028–2039.

81. Raterman H. G., Lems W. F. Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide. Drugs Aging. 2019 Dec; 36 (12): 1061–1072.

82. Мясоедова С. Е., Рубцова О. А. Эффективность комплекса лечебно-реабилитационных мероприятий больных ревматоидным артритом с учетом коморбидности по остепорозу. Курортная медицина. 2016. № 2. С. 76–79.

83. Molto A., Etcheto A., Van Der Heijde D. et al. Prevalence of Comorbidities and Evaluation of Their Screening in Spondyloarthritis: Results of the International Cross-Sectional ASAS-COMOSPA Study. Ann. Rheum. Dis. 2016; 75: 1016–1023.

84. Ramirez J., Nieto-Gonzalez J.C., Curbelo Rodriguez R. et. al. Prevalence and Risk Factors for Osteoporosis and Fractures in Axial Spondyloarthritis: A Systematic Review and Meta-Analysis. Semin. Arthritis Rheum. 2018; 48: 44–52.

85. Weiss R.J., Wick M. C., Ackermann P. W., Montgomery S. M. Increased Fracture Risk in Patients with Rheumatic Disorders and Other Inflammatory Diseases – A Case-Control Study with 53,108 Patients with Fracture. J. Rheumatol. 2010; 37: 2247–2250.

86. Vosse D., Landewe R., Van Der Heijde D. et. al. Ankylosing Spondylitis and the Risk of Fracture: Results from a Large Primary Care-Based Nested Case-Control Study. Ann. Rheum. Dis. 2009; 68: 1839–1842.

87. Munoz-Ortego J., Vestergaard P., Rubio J.B.et. al. Ankylosing Spondylitis is Associated with an Increased Risk of Vertebral and Nonvertebral Clinical Fractures: A Population-Based Cohort Study. J. Bone Miner. Res. 2014; 29: 1770–1776.

88. Montala N., Juanola X., Collantes E. et al. Prevalence of Vertebral Fractures by Semiautomated Morphometry in Patients with Ankylosing Spondylitis. J. Rheumatol. 2011; 38: 893–897.

89. Акулова А. И., Гайдукова И. З., Мысин М. А. и др. Фенотипирование позвонков у больных со спондилоартритами Бюллетень медицинских Интернетконференций (ISSN 2224–6150) 2016. Том 6. № 6.

90. Ghozlani I., Ghazi M., Nouijai A. et. al. Prevalence and Risk Factors of Osteoporosis and Vertebral Fractures in Patients with Ankylosing Spondylitis. Bone. 2009; 44: 772–776.

91. van der Weijden M. A.C., Claushuis T. A.M., Nazari T. et. al. High Prevalence of Low Bone Mineral Density in Patients within 10 Years of Onset of Ankylosing Spondylitis: A Systematic Review. Clin. Rheumatol. 2012; 31: 1529–1535.

92. Maas F., Spoorenberg A., Van Der Slik B. P.G. et. al. Clinical Risk Factors for the Presence and Development of Vertebral Fractures in Patients with Ankylosing Spondylitis. Arthritis Care Res. 2017; 69: 694–702.

93. Briot K., Durnez A., Paternotte S.et. al. Bone Oedema on MRI is Highly Associated with Low Bone Mineral Density in Patients with Early Inflammatory Back Pain: Results from the DESIR Cohort. Ann. Rheum. Dis. 2013; 72: 1914–1919.

94. Akgol G., Kamanlı A., Ozgocmen S. Evidence for Inflammation-Induced Bone Loss in Non-Radiographic Axial Spondyloarthritis. Rheumatology. 2014; 53:497–501.

95. Губарь Е. Е., Дубинина Т. В., Дёмина А. Б. и др. Изменяется ли минеральная плотность кости при раннем аксиальном спондилоартрите? Научно-практическая ревматология. 2016; 54 (Прил. 1): 29–32.

96. Schett G, David JP. The multiple faces of autoimmune-mediated bone loss. Nat Rev Endocrinol. 2010 Dec;6 (12): 698–706.

97. Neumann A., Haschka J., Kleyer A. et al. Cortical Bone Loss is An Early Feature of Nonradiographic Axial Spondyloarthritis. ArthritisRes. Ther. 2018; 20: 202.

98. Rossini M, Viapiana O, Idolazzi L et. al. Higher Level of Dickkopf-1 is Associated with Low Bone Mineral Density and Higher Prevalence of Vertebral Fractures in Patients with Ankylosing Spondylitis. Calcif Tissue Int. 2016 May; 98 (5): 438–45.

99. Гайдукова И. З., Дорогойкина К. Д., Акулова А. И. и др. Компрессионные изменения тел позвонков у больных аксиальными спондилоартритами, включая анкилозирующий спондилит. Фарматека. 2017; 18: 36–40.

100. Раскина Т. А., Малышенко О. С., Пирогова О. А. и др. Влияние противовоспалительной терапии на минеральную плотность кости у больных анкилозирующим спондилитом: результаты проспективного наблюдения. Фундаментальная и клиническая медицина. 2016; 1 (1): 6–15.

101. Haroon N. N., Sriganthan J., Al Ghanim N. et. al. Effect of TNF-Alpha Inhibitor Treatment on Bone Mineral Density in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis. Semin. Arthritis Rheum. 2014; 44: 155–161.

102. Beek K.J., Rusman T., Van Der Weijden M.A.C. et. al. Long-Term Treatment with TNF-Alpha Inhibitors Improves Bone Mineral Density but Not Vertebral Fracture Progression in Ankylosing Spondylitis. J. Bone Miner. Res. 2019; 34: 1041–1048.

103. Ogdie A., Harter L., Shin D. et. al. The Risk of Fracture Among Patients with Psoriatic Arthritis and Psoriasis: A Population-Based Study. Ann. Rheum. Dis. 2017; 76: 882–885.

104. Chen TL, Lu JW, Huang YW et al. Bone Mineral Density, Osteoporosis, and Fracture Risk in Adult Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Observational Studies. J Clin Med. 2020; 9 (11):3712. Published 2020 Nov 19.

105. Cranney AB, McKendry RJ, Wells GA, et al. The effect of low dose methotrexate on bone density. J Rheumatol. 2001 Nov; 28 (11): 2395–9.

106. Patel S, Patel G, Johnson D. et. al. Effect of low dose weekly methotrexate on bone mineral density and bone turnover. Ann Rheum Dis. 2003; 62 (2): 186–187.

107. Szentpetery A., McKenna M., Murray B. et al. Periarticular bone gain at proximal interphalangeal joints and changes in bone turnover markers in response to tumor necrosis factor inhibitors in rheumatoid and psoriatic arthritis The Journal of Rheumatology 2013; 40 (5): 653–662.

108. Simon D., Kleyer A., Bayat S. et al. Effect of Disease-Modifying anti-Rheumatic Drugs on Bone Structure and Strength in Psoriatic Arthritis Patients. Arthritis Res. Ther. 2019; 21: 162.

109. Bultink I. E.M., Lems W. F. Lupus and Fractures. Curr. Opin. Rheumatol. 2016; 28: 426–432.

110. Mahmoud K., Zayat A., Vital E. M. Musculoskeletal Manifestations of Systemic Lupus Erythmatosus. Curr. Opin. Rheumatol. 2017; 29: 486–492.

111. Шкиреева С. Ю., Лесняк О. М., Зоткин Е. Г. Бессимптомные компрессионные переломы позвонков у женщин в постменопаузе с системной красной волчанкой. Научно-практическая ревматология. 2017; 55 (1): 26–31.

112. Tedeschi S. K., Kim S. C., Guan H. et. al. Comparative Fracture Risks Among United States Medicaid Enrollees with and Those without Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019; 71: 1141–1146.

113. Wang X., Yan S., Liu C. et al. Fracture risk and Bone Mineral Density Levels in Patients with Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis. Osteoporos. Int. 2016; 27: 1413–1423.

114. Асеева Е. А., Соловьев С. К., Клюквина Н. Г. и др. Необратимые органные повреждения в когорте пациентов с системной красной волчанкой (РЕНЕССАНС). Научно-практическая ревматология. 2016; 54 (4): 404–411.

115. Заводовский Б. В., Сивордова Л. Е., Полякова Ю. В. Возможности альфакальцидола при фармакологической коррекции нарушений ремоделирования костной ткани у больных системной красной волчанкой. Символ науки: Международный научный журнал. 2015; 8: 258–260.

116. Fanouriakis A., Kostopoulou M., Alunno A. et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann. Rheum. Dis. 2019; 78: 736–745.

117. Lim S. H.L., Benseler S. M., Tyrrell P. N.et. al. Low Bone Mineral Density is Present in Newly Diagnosed Paediatric Systemic Lupus Erythematosus Patients. Ann. Rheum. Dis. 2011; 70: 1991–1994.

118. Lahita R. G., Bradlow H. L., Ginzler E. et. al. Low Plasma Androgens in Women with Systemic Lupus Erythematosus. Arthritis Rheum. 1987; 30: 241–248.

119. Formiga F., Moga I., Nolla J. M. et al. The Association of Dehydroepiandrosterone Sulphate Levels with Bone Mineral Density in Systemic Lupus Erythematosus. Clin. Exp. Rheumatol. 1997; 15: 387–392.

120. Almehed K., ForsbladD’Elia H., Kvist G. et. al. Prevalence and Risk Factors of Osteoporosis in Female SLE Patients-Extended Report. Rheumatology. 2007; 46: 1185–1190.

121. Bultink I. E.M., Lems W. F., Kostense P. J. et. al. Prevalence of and Risk Factors for Low Bone Mineral Density and Vertebral Fractures in Patients with Systemic Lupus Erythematosus. Arthritis Rheum. 2005; 52: 2044–2050.

122. Lakshminarayanan S., Walsh S., Mohanraj M., Rothfeld N. Factors Associated with Low Bone Mineral Density in Female Patients with Systemic Lupus Erythematosus. J. Rheumatol. 2001; 28: 102–108.

123. Cramarossa G., Urowitz M. B., Su J. et. al. Prevalence and Associated Factors of Low Bone Mass in Adults with Systemic Lupus Erythematosus. Lupus. 2017; 26: 365–372.

124. Omair M.A., Pagnoux C., McDonald-Blumer H., Johnson S.R. Low Bone Density in Systemic Sclerosis. A Systematic Review. J. Rheumatol. 2013; 40: 1881–1890.

125. Frediani B., Baldi F., Falsetti P. et al. Bone Mineral Density in Patients with Systemic Sclerosis. Ann. Rheum. Dis. 2004; 63: 326–327.

126. Sampaio-Barros P.D., Costa-Paiva L., Filardi S. et. al. Prognostic Factors of Low Bone Mineral Density in Systemic Sclerosis. Clin. Exp. Rheumatol. 2005; 23: 180–184.

127. Caimmi C., Caramaschi P., Barausse G. et. al. Bone Metabolism in a Large Cohort of Patients with Systemic Sclerosis. Calcif. Tissue Int. 2016; 99: 23–29.

128. Di Munno O., Mazzantini M., Massei P. et. al. Reduced Bone Mass and Normal Calcium Metabolism in Systemic Sclerosis with and without Calcinosis. Clin. Rheumatol. 1995; 14: 407–412.

129. Добровольская О. В., Демин Н. В., Смирнов А. В. и др. Состояние минеральной плотности кости у пациентов с системной склеродермией. Современная ревматология. 2019; 13 (1): 58–63.

130. Atteritano M., Sorbara S., Bagnato G. et. al. Bone Mineral Density, Bone Turnover Markers and Fractures in Patients with Systemic Sclerosis: A Case Control Study. PLoS One. 2013; 8: e66991.]

131. Avouac J., Koumakis E., Toth E. et. al. Increased Risk of Osteoporosis and Fracture in Women with Systemic Sclerosis: A Comparative Study with Rheumatoid Arthritis. Arthritis Care Res. 2012; 64: 1871–1878.

132. Loucks J., Pope J. E. Osteoporosis in Scleroderma. Semin Arthritis Rheum. 2005; 34: 678–682.

133. Koumakis E., Avouac J., Winzenrieth R. et. al. Trabecular Bone Score in Female Patients with Systemic Sclerosis: Comparison with Rheumatoid Arthritis and Influence of Glucocorticoid Exposure. J. Rheumatol. 2015; 42: 228–233.

134. Ruaro B., Casabella A., Paolino S. et. al. Dickkopf-1 (Dkk-1) Serum Levels in Systemic Sclerosis and Rheumatoid Arthritis Patients: Correlation with the Trabecular Bone Score (TBS) Clinical. Rheumatol. 2018; 37: 3057–3062.

135. Ефремова АО, Торопцова НВ, Добровольская ОВ и др. Риск переломов и потребность в антиостеопоротическом лечении у больных системной склеродермией. Современная ревматология. 2021; 15 (1): 32–37.

136. Hu Z., Zhu S., Zhang B. Impaired Bone Health in Patients with Primary Sjogren’s Syndrome. Arthritis Rheumatol. 2016; 68 (Suppl. 10).

137. Lai E. L., Huang W. N. Ten-Year Fracture Risk by FRAX and Osteoporotic Fractures in Patients with Systemic Autoimmune Diseases. Lupus. 2019; 28: 945–953.

138. Albrecht K, Dörner T, Redeker I. et. al. Comorbidity and health care utilisation in persons with Sjögren's syndrome: a claims data analysis. Clin Exp Rheumatol. 2020 Jul-Aug; 38 Suppl 126 (4): 78–84.

139. de Andrade DC, de Magalhães Souza SC, de Carvalho JF. et. al. High frequency of osteoporosis and fractures in women with dermatomyositis/polymyositis. Rheumatol Int. 2012 Jun; 32 (6): 1549–53.

140. Vincze A, Bodoki L, Szabó K, et al. The risk of fracture and prevalence of osteoporosis is elevated in patients with idiopathic inflammatory myopathies: cross-sectional study from a single Hungarian center. BMC Musculoskelet Disord. 2020; 21 (1): 426.

141. Gupta L, Lawrence A, Edavalath S, Misra R. Prevalence and predictors of asymptomatic vertebral fractures in inflammatory myositis. Int J Rheum Dis. 2018 Mar; 21 (3): 725–731.

142. Ganguly S, Lawrence A, Gupta L. Prevalent vertebral fractures incur high risk of future fractures in inflammatory myositis. ClinRheumatol. 2021 Apr; 40 (4):1431–1436.

143. Paskins Z., Whittle R., Sultan A. A. et. al. Risk of Fracture Among Patients with Polymyalgia Rheumatica and Giant Cell Arteritis: A Population-Based Study. BMC Medicine. 2018; 16: 4.

144. Boomsma M. M., Stegeman C. A., Kramer A. B. et. al. Prevalence of Reduced Bone Mineral Density in Patients with Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis and the Role of Immunosuppressive Therapy: A Cross-Sectional Study. Osteoporos. Int. A J. Establ. Result Coop. Eur. Found. Osteoporos. Natl. Osteoporos. Found. USA. 2002; 13: 74–82.

145. Robson J., Doll H., Suppiah R. et. al. Damage in the Anca-Associated Vasculitides: Long-Term Data from the European Vasculitis Study Group (EUVAS) Therapeutic Trials. Ann. Rheum. Dis. 2015; 74: 177–184.

146. Samson M., Puechal X., Devilliers H. et al. Long-Term Follow-Up of a Randomized Trial on 118 Patients with Polyarteritis Nodosa or Microscopic Polyangiitis without Poor-Prognosis Factors. Autoimmun. Rev. 2014; 13: 197–205.

147. Rozenberg S, Bruyère O, Bergmann P, et al. How to manage osteoporosis before the age of 50. Maturitas. 2020 Aug; 138: 14–25.

148. Торопцова Н. В. Глюкокортикоидный остеопороз: диагностика, профилактика и лечение. Научно-практическая ревматология. 2014; 52 (4): 423–429.

149. Stathopoulos IP, Liakou CG, Katsalira A, et al. The use of bisphosphonates in women prior to or during pregnancy and lactation. Hormones (Athens). 2011 Oct-Dec; 10 (4): 280–91.

150. Добровольская О.В., Демин Н.В., Смирнов А.В., Торопцова Н.В. Состояние минеральной плотности костной ткани и потребность в противоостеопоротической терапии у женщин в постменопаузе с системной склеродермией. Медицинский совет. 2019; 9: 72–79.

151. Баранова И. А., Торопцова Н. В., Лесняк О. М. Основные положения клинических рекомендаций «Диагностика, профилактика и лечение глюкокортикоидного остеопороза у мужчин и женщин 18 лет и старше». Остеопороз и остеопатии. 2014; 17 (3): 34–37.

152. Торопцова Н. В. Глюкокортикоидный остеопороз: представление и обсуждение новых клинических рекомендаций Американского колледжа ревматологов. Остеопороз и остеопатии. 2017; 20 (3): 114–120.

153. de Nijs RN, Jacobs JW, Algra A, et al. Prevention and treatment of glucocorticoid-induced osteoporosis with active vitamin D 3 analogues: a review with meta-analysis of randomized controlled

154. trials including organ transplantation studies. Osteoporos Int. 2004;15 (8): 589–602.