Do the Drugs Used to Treat Rheumatic Disorders Induce Bone Fragility? A Review

Rheumatic disorders are linked to immuno-logical processes in the body; therefore, drugs used to treat these disorders may interfere with the immune system. The immune system shares several signaling mechanisms with bone cells, both directly via cytokines and prostaglandins, and indirectly via vitamin D, which is also an active immunological substance. As a result, drugs used to modulate the immune response may interfere with bone mineral density (BMD), bone biomechanical competence, and the risk of fractures [1–3].