Impaired Bone Physiology in Rheumatoid Arthritis: Can the Wnt Pathway be the Connecting Link Between the Synovium and the Bone?

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.