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With the introduction of very effective tumour-necrosis factor-blockers and other biologics, clinical remission is a realistic target in around half of the early patients with RA; the same appears true for the use of methotrexate with chronic low dose or initially high-dose GCs. With the use of a treat-to-target strategy focusing on clinical remission or low disease activity in early patients with RA, the negative effects of systemic inflammation on bone can be inhibited and local bone loss (in the joints), and generalised bone loss at the spine and hips, can be limited or prevented. Whether this also leads to a reduction in vertebral and non-vertebral fractures remains to be demonstrated. Another issue is, in other systemic rheumatic diseases in which treatment options are smaller and less effective than in RA, local and systemic bone loss may still occur.<\/jats:p>","DOI":"10.1136\/rmdopen-2015-000050","type":"journal-article","created":{"date-parts":[[2015,8,15]],"date-time":"2015-08-15T19:58:12Z","timestamp":1439668692000},"page":"e000050","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Glucocorticoids: bad or safe for the bones?"],"prefix":"10.1136","volume":"1","author":[{"given":"Willem F","family":"Lems","sequence":"first","affiliation":[{"name":"Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,8,15]]},"reference":[{"key":"2025090313544175000_1.Suppl_1.e000050.1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199909)42:9<1854::AID-ANR9>3.0.CO;2-F"},{"key":"2025090313544175000_1.Suppl_1.e000050.2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200003)43:3<522::AID-ANR7>3.0.CO;2-Y"},{"key":"2025090313544175000_1.Suppl_1.e000050.3","doi-asserted-by":"crossref","unstructured":"Gough AK , Lilley J , Eyre S , et al . 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