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Letter to the Editor|Articles in Press

Reply to letter to the editor by Yoshii

Published:March 10, 2023DOI:https://doi.org/10.1016/j.jos.2023.02.023
      We express our sincere gratitude to Dr. Yoshii for showing keen interest in our manuscript [
      • Nagayama Y.
      • Ebina K.
      • Tsuboi H.
      • Hirao M.
      • Hashimoto J.
      • Yoshikawa H.
      • Okada S.
      • Nakata K.
      Low serum albumin concentration is associated with increased risk of osteoporosis in postmenopausal patients with rheumatoid arthritis.
      ]. We strongly concur with his comment that achieving sustained clinical remission, as measured by the Simplified Disease Activity Index (SDAI), alongside monitoring serum albumin levels, is crucial in preventing osteoporosis and bone fragility fractures (BFF) in patients with rheumatoid arthritis (RA) [
      • Yoshii I.
      • Chijiwa T.
      • Sawada N.
      Rheumatoid arthritis in tight disease control is no longer risk of bone mineral density loss.
      ]. This is because elevated disease activity, which is not only associated with hypoalbuminemia [
      • Wilkinson P.
      • Jeremy R.
      • Brooks F.P.
      • Hollander J.L.
      The mechanism of hypoalbuminemia in rheumatoid arthritis.
      ] but also to higher levels of pro-inflammatory cytokines such as tumor necrosis factor-alpha and interleukin-6, can trigger osteoclastogenesis while impeding osteogenesis [
      • Tanaka Y.
      Clinical immunity in bone and joints.
      ].
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      References

        • Nagayama Y.
        • Ebina K.
        • Tsuboi H.
        • Hirao M.
        • Hashimoto J.
        • Yoshikawa H.
        • Okada S.
        • Nakata K.
        Low serum albumin concentration is associated with increased risk of osteoporosis in postmenopausal patients with rheumatoid arthritis.
        J Orthop Sci. 2022 Nov; 27: 1283-1290
        • Yoshii I.
        • Chijiwa T.
        • Sawada N.
        Rheumatoid arthritis in tight disease control is no longer risk of bone mineral density loss.
        Osteoporos Sarcopenia. 2020 Jun; 6: 75-81
        • Wilkinson P.
        • Jeremy R.
        • Brooks F.P.
        • Hollander J.L.
        The mechanism of hypoalbuminemia in rheumatoid arthritis.
        Ann Intern Med. 1965 Jul; 63: 109-114
        • Tanaka Y.
        Clinical immunity in bone and joints.
        J Bone Miner Metabol. 2019 Jan; 37: 2-8