風濕性疾病容易引起局部性或全身性的骨質疏鬆症，全身性的發炎會導致局部骨 質流失及侵蝕。近年來，因科學家對風濕病的發炎過程有更進一步的瞭解，而開發了 cytokines 的有效抑制劑，即疾病調節抗風濕藥物 (disease-modifying antirheumatic drugs, DMARDs)。這些治療可減少全身性的發炎及對局部性骨質流失的影響。腫瘤壞死因子 α- 抑製劑 (tumor necrosis factor α-inhibitor)、IL-6 (interleukin 6) 及 IL-1 抑制劑、JAK (janus kinase) 抑制劑、CTLA4 (cytotoxic T-lymphocyte-associated protein 4) 作用劑及 rituximab 也可以減緩骨侵蝕的進展。不同的 DMARDs 對骨礦物質影響不同。本文綜述 DMARDs 對風濕症病人，預防骨質及骨侵蝕的效果。

 

Osteoporosis is a well-known complication in rheumatic diseases and systemic inflammation can lead to localized bone loss and erosion. In recent years, an increased understanding of the inflammatory process in rheumatism has led to the development of potent inhibitors of cytokines; it is a disease-modulating antirheumatic drug. These treatments could reduce systemic inflammation and affect localized bone loss. Although Tumor Necrosis factor α-inhibitors (TNF α-inhibitors), IL-6 (interleukin 6) and IL-1 inhibitors, JAK (janus kinase) inhibitors, CTLA4 (cytotoxic T-lymphocyte-associated protein 4) agents, and rituximab can also slow down the progression of bone erosion, different DMARDs have different effects on bone mineral. This article reviewed the effects of DMARDs, TNF α-inhibitors, IL-6, and IL-1 inhibitors, JAK inhibitors, CTLA4 agents, and rituximab on the prevention of bone and bone erosion in patients with rheumatic diseases.

 

Summited for publication: 2022.4.15; Accepted for publication: 2022.6.14