Objective: To elaborate recommendations of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology (SBR) to manage comorbidities in rheumatoid arthritis (RA). Methods: To review the literature and the opinions of the SBR RA Committee experts. Results and conclusions: Recommendations: 1) Early diagnosis and proper treatment of comorbidities are recommended; 2) The specific treatment of RA should be adapted to the presence of comorbidities; 3) Angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers are preferred to treat systemic arterial hypertension; 4) In patients diagnosed with rheumatoid arthritis and diabetes mellitus, the continuous use of a high cumulative dose of corticoids should be avoided; 5) Statins should be used to maintain LDL cholesterol levels under 100 mg/dL and the atherosclerotic index lower than 3.5 in patients with RA who have other comorbidities; 6) Metabolic syndrome should be treated; 7) Performing non-invasive tests to investigate subclinical atherosclerosis is recommended; 8) Greater surveillance for the early diagnosis of occult malignancy is recommended; 9) Preventive measures of venous thrombosis are suggested; 10) Bone densitometry is recommended in RA patients over the age of 50 years and in younger patients on corticoid therapy at a dose greater than 7.5 mg for over three months; 11) Patients with RA and osteoporosis should be instructed to avoid falls, to increase their dietary calcium intake and sun exposure, and to exercise; 12) Calcium and vitamin D supplementation is suggested. Bisphosphonates are suggested for patients with T score < -2.5 on bone densitometry; 13) A multidisciplinary team, with the active participation of a rheumatologist, is recommended to treat comorbidities. © 2012 Elsevier Editora Ltda.524483495McInnes, I.B., O'Dell, J.R., State-of-the-art: rheumatoid arthritis (2010) Ann Rheum Dis, 69 (11), pp. 1898-1906. , [Erratum in: Ann Rheum Dis 201170(2):399]McInnes, I.B., Schett, G., The pathogenesis of rheumatoid arthritis (2011) N Engl J Med, 365 (23), pp. 2205-2219Allaart, C.F., Huizinga, T.W., Treatment strategies in recent onset rheumatoid arthritis (2011) Curr Opin Rheumatol, 23 (3), pp. 241-244Symmons, D.P., Rheumatoid arthritis: assessing disease activity and outcome (2010) Clin Med, 10 (3), pp. 248-251Gonzalez, A., Maradit Kremers, H., Crowson, C.S., Nicola, P.J., Davis 3rd, J.M., Therneau, T.M., The widening mortality gap between rheumatoid arthritis patients and the general population (2007) Arthritis Rheum, 56 (11), pp. 3583-3587Hemminki, K., Li, X., Sundquist, J., Sundquist, K., Familial associations of rheumatoid arthritis with autoimmune diseases and related conditions (2009) Arthritis Rheum, 60 (3), pp. 661-668Michou, L., Rat, A.C., Lasbleiz, S., Bardin, T., Cornélis, F., Prevalence and distribution of autoimmune diseases in 368 rheumatoid arthritis families (2008) J Rheumatol, 35 (5), pp. 790-796Michaud, K., Wolfe, F., Comorbidities in rheumatoid arthritis (2007) Best Pract Res Clin Rheumatol, 21 (5), pp. 885-906Crowson, C.S., Myasoedova, E., Davis 3rd, J.M., Matteson, E.L., Roger, V.L., Therneau, T.M., Increased Prevalence of metabolic syndrome associated with rheumatoid arthritis in patients without clinical cardiovascular disease (2011) J Rheumatol, 38 (1), pp. 29-35Chung, C.P., Oeser, A., Solus, J.F., Avalos, I., Gebretsadik, T., Shintani, A., Prevalence of the metabolic syndrome is increased in rheumatoid arthritis and is associated with coronary atherosclerosis (2008) Atherosclerosis, 196 (2), pp. 756-763Steiner, G., Urowitz, M.B., Lipid profiles in patients with rheumatoid arthritis: mechanisms and the impact of treatment (2009) Semin Arthritis Rheum, 38 (5), pp. 372-381Solomon, D.H., Love, T.J., Canning, C., Schneeweiss, S., Risk of diabetes among patients with rheumatoid arthritis, psoriatic arthritis and psoriasis (2010) Ann Rheum Dis, 69 (12), pp. 2114-2117van Halm, V.P., Peters, M.J., Voskuyl, A.E., Boers, M., Lems, W.F., Visser, M., Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease: a cross-sectional study, the CARRE Investigation (2009) Ann Rheum Dis, 68 (9), pp. 1395-1400Panoulas, V.F., Douglas, K.M., Milionis, H.J., Stavropoulos-Kalinglou, A., Nightingale, P., Kita, M.D., Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis (2007) Rheumatology (Oxford), 46 (9), pp. 1477-1482Kitas, G.D., Gabriel, S.E., Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives (2011) Ann Rheum Dis, 70 (1), pp. 8-14Gonzalez, A., Maradit Kremers, H., Crowson, C.S., Ballman, K.V., Roger, V.L., Jacobsen, S.J., Do cardiovascular risk factors confer the same risk for cardiovascular outcomes in rheumatoid arthritis patients as in nonrheumatoid arthritis patients? (2008) Ann Rheum Dis, 67 (1), pp. 64-69Panoulas, V.F., Douglas, K.M., Stavropoulos-Kalinoglou, A., Metsios, G.S., Nightingale, P., Kita, M.D., Long-term exposure to medium-dose glucocorticoid therapy associates with hypertension in patients with rheumatoid arthritis (2008) Rheumatology (Oxford), 47 (1), pp. 72-75Alcorn, N., Saunders, S., Madhok, R., Benefit-risk assessment of leflunomide: an appraisal of leflunomide in rheumatoid arthritis 10 years after licensing (2009) Drug Saf, 32 (12), pp. 1123-1134Robert, N., Wong, G.W., Wright, J.M., Effect of cyclosporine on blood pressure (2010) Cochrane Database Syst Rev, (1), pp. CD007893Atzeni, F., Turiel, M., Caporali, R., Cavagna, L., Tomasoni, L., Sitia, S., The effect of pharmacological therapy on the cardiovascular system of patients with systemic rheumatic diseases (2010) Autoimmunity Rev, 9 (12), pp. 835-839White, W.B., Defining the problem of treating the patient with hypertension and arthritis pain (2009) Am J Med, 122 (5 SUPPL.), pp. S3-S9Peters, M.J., Symmons, D.P., McCarey, D., Dijkmans, B.A., Nicola, P., Kvien, T.K., EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis (2010) Ann Rheum Dis, 69 (2), pp. 325-331Solomon, D.H., Massarotti, E., Garg, R., Liu, J., Canning, C., Schneeweiss, S., Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis (2011) JAMA, 305 (24), pp. 2525-2531Tentolouris, N., Arapostathi, C., Voulgari, C., Grammatikou, S., Andrianakos, A., Sfikakis, P.P., The effect of diabetes mellitus on the prevalence of rheumatoid arthritis: a case-control study (2008) Diabet Med, 25 (8), pp. 1010-1011Han, C., Robinson Jr., D.W., Hackett, M.V., Paramore, L.C., Fraeman, K.H., Bala, M.V., Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis (2006) J Rheumatol, 33 (11), pp. 2167-2172Hoes, J.N., van der Goes, M.C., van Raalte, D.H., van der Zijl, N.J., den Uyl, D., Lems, W.F., Glucose tolerance, insulin sensitivity and β-cell function in patients with rheumatoid arthritis treated with or without low-to-medium dose glucocorticoids (2011) Ann Rheum Dis, 70 (11), pp. 1887-1894Wasko, M.C., Kay, J., Hsia, E.C., Rahman, M.U., Diabetes mellitus and insulin resistance in patients with rheumatoid arthritis: risk reduction in a chronic inflammatory disease (2011) Arthritis Care Res (Hoboken), 63 (4), pp. 512-521Antohe, J.L., Bili, A., Sartorius, J.A., Lester Kirchner, H., Morris, S.J., Dancea, S., Diabetes risk in rheumatoid arthritis: Reduced incidence with anti-tumor necrosis factor- α therapy (2012) Arthritis Care Res (Hoboken), 64 (2), pp. 215-221Bili, A., Sartorius, J.A., Kirchner, H.L., Morris, S.J., Ledwich, L.J., Antohe, J.L., Hydroxychloroquine use and decreased risk of diabetes in rheumatoid arthritis patients (2011) J Clin Rheumatol, 17 (3), pp. 115-120Liao, K.P., Gunnarsson, M., Källberg, H., Ding, B., Plenge, R.M., Padyukov, L., Specific association of type 1 diabetes mellitus with anti-cyclic citrullinated peptide-positive rheumatoid arthritis (2009) Arthritis Rheum, 60 (3), pp. 653-660Choy, E., Sattar, N., Interpreting lipid levels in the context of highgrade inflammatory states with a focus on rheumatoid arthritis: a challenge to conventional cardiovascular risk actions (2009) Ann Rheum Dis, 68 (4), pp. 460-469White, D., Fayez, S., Doube, A., Atherogenic lipid profiles in rheumatoid arthritis (2006) N Z Med J, 119 (1240), pp. U2125Nurmohamed, M.T., Atherogenic lipid profiles and its management in patients with rheumatoid arthritis (2007) Vasc Health Risk Manag, 3 (6), pp. 845-852Myasoedova, E., Crowson, C.S., Kremers, H.M., Fitz-Gibbon, P.D., Therneau, T.M., Gabriel, S.E., Total cholesterol and LDL levels decrease before rheumatoid arthritis (2010) Ann Rheum Dis, 69 (7), pp. 1310-1314Ghosh, U.C., Roy, A., Sen, K., Kundu, A.K., Saha, I., Biswas, A., Dyslipidaemia in rheumatoid arthritis in a tertiary care centre in Eastern India - a non-randomised trial (2009) J Indian Med Assoc, 107 (7), pp. 427-430Garciaa-Gómez, C., Nolla, J.M., Valverde, J., Gómez-Gerique, J.A., Castro, M.J., Pintó, X., Conventional lipid profile and lipoprotein(a) concentrations in treated patients with rheumatoid arthritis (2009) J Rheumatol, 36 (7), pp. 1365-1370Steiner, G., Urowitz, M.B., Lipid profiles in patients with rheumatoid arthritis: mechanisms and the impact of treatment (2009) Semin Arthritis Rheum, 38 (5), pp. 372-381Georgiadis, A.N., Papavasiliou, E.C., Lourida, E.S., Alamanos, Y., Kostara, C., Tselepis, A.D., Atherogenic lipid profile is a feature characteristic of patients with early rheumatoid arthritis: effect of early treatment - a prospective, controlled study (2006) Arthritis Res Ther, 8 (3), pp. R82Svenson, K.L., Lithell, H., Hallgren, R., Vessby, B., Serum lipoprotein in active rheumatoid arthritis and other chronic inflammatory arthritides. II. Effects of anti-inflammatory and disease-modifying drug treatment (1987) Arch Intern Med, 147 (11), pp. 1917-1920Raynauld, J.P., Cardiovascular mortality in rheumatoid arthritis: how harmful are corticosteroids? (1997) J Rheumatol, 24 (3), pp. 415-416Wallace, D.J., Metzger, A.L., Stecher, V.J., Turnbull, B.A., Kern, P.A., Cholesterol-lowering effect of hydroxychloroquine in patients with rheumatic disease: reversal of deleterious effects of steroids on lipids (1990) Am J Med, 89 (3), pp. 322-326van Halm, V.P., Nielen, M.M., Nurmohamed, M.T., van Schaardenburg, D., Reesink, H.W., Voskuyl, A.E., Lipids and inflammation: serial measurements of the lipid profile of blood donors who later developed rheumatoid arthritis (2007) Ann Rheum Dis, 66 (2), pp. 184-188Singh, J.A., Beg, S., Lopez-Olivo, M.A., Tocilizumab for rheumatoid arthritis. Cochrane Database of Systematic Reviews (2011) J Rheumatol, 38 (1), pp. 10-20Storage, S.S., Agrawal, H., Furst, D.E., Description of the efficacy and safety of three new biologics in the treatment of rheumatoid arthritis (2010) Korean J Intern Med, 25 (1), pp. 1-17Pollono, E.N., Lopez-Olivo, M.A., Lopez, J.A., Suarez-Almazor, M.E., A systematic review of the effect of TNF-alpha antagonists on lipid profiles in patients with rheumatoid arthritis (2010) Clin Rheumatol, 29 (9), pp. 947-955McCarey, D.W., McInnes, I.B., Madhok, R., Hampson, R., Scherbakov, O., Ford, I., Trial of Atorvastatin in Rheumatoid Arthritis (TARA): double-blind, randomised placebo-controlled trial (2004) Lancet, 363 (9426), pp. 2015-2021Chatterjee Adhikari, M., Guin, A., Chakraborty, S., Sinhamahapatra, P., Ghosh, A., Subclinical atherosclerosis and endothelial dysfunction in patients with early rheumatoid arthritis as evidenced by measurement of carotid intima-media thickness and flow-mediated vasodilatation: an observational study (2012) Semin Arthritis Rheum, 41 (5), pp. 669-675González-Juanatey, C., Llorca, J., González-Gay, M.A., Correlation between endothelial function and carotid atherosclerosis in rheumatoid arthritis patients with long-standing disease (2011) Arthritis Res Ther, 13 (3), pp. R101Pereira, I.A., Laurindo, I.M., Zimmermann, A.F., Werner Castro, G.R., Mello, F., Borba, E.F., Single measurements of C-reactive protein and disease activity scores are not predictors of carotid atherosclerosis in rheumatoid arthritis patients (2009) Acta Reumatol Port, 34 (1), pp. 58-64Chung, C.P., Oeser, A., Raggi, P., Gebretsadik, T., Shintani, A.K., Sokka, T., Increased coronary-artery atherosclerosis in rheumatoid arthritis: relationship to disease duration and cardiovascular risk factors (2005) Arthritis Rheum, 52 (10), pp. 3045-3053Maradit-Kremers, H., Crowson, C.S., Nicola, P.J., Ballman, K.V., Roger, V.L., Jacobsen, S.J., Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study (2005) Arthritis Rheum, 52 (2), pp. 402-411Nicola, P.J., Maradit-Kremers, H., Roger, V.L., Jacobsen, S.J., Crowson, C.S., Ballman, K.V., The risk of congestive heart failure in rheumatoid arthritis: a population-based study over 46 years (2005) Arthritis Rheum, 52 (2), pp. 412-420Westlake, S.L., Colebatch, A.N., Baird, J., Kiely, P., Quinn, M., Choy, E., The effect of methotrexate on cardiovascular disease in patients with rheumatoid arthritis: a systematic literature review (2010) Rheumatology (Oxford), 49 (2), pp. 295-307Westlake, S.L., Colebatch, A.N., Baird, J., Curzen, N., Kiely, P., Quinn, M., Tumour necrosis factor antagonists and the risk of cardiovascular disease in patients with rheumatoid arthritis: a systematic literature review (2011) Rheumatology (Oxford), 50 (3), pp. 518-531Barnabe, C., Martin, B.J., Ghali, W.A., Systematic review and metaanalysis: anti-tumor necrosis factor a therapy and cardiovascular events in rheumatoid arthritis (2011) Arthritis Care Res (Hoboken), 63 (4), pp. 522-529Gislason, G.H., Rasmussen, J.N., Abildstrom, S.Z., Schramm, T.K., Hansen, M.L., Fosbøl, E.L., Increased mortality and cardiovascular morbidity associated with use of nonsteroidal anti-inflammatory drugs in chronic heart failure (2009) Arch Intern Med, 169 (2), pp. 141-149Solomon, D.H., Glynn, R.J., Rothman, K.J., Schneeweiss, S., Setoguchi, S., Mogun, H., Subgroup analyses to determine cardiovascular risk associated with nonsteroidal anti-inflammatory drugs and coxibs in specific patient groups (2008) Arthritis Rheum, 59 (8), pp. 1097-1104Söderlin, M., Petersson, I., Bergman, S., Svensson, B., Smoking at onset of rheumatoid arthritis (RA) and its effect on disease activity and functional status: experiences from BARFOT, a long-term observational study on early RA (2011) Scand J Rheumatol, 40 (4), pp. 249-255. , BARFOT study groupSaevarsdottir, S., Wedrén, S., Seddighzadeh, M., Bengtsson, C., Wesley, A., Lindblad, S., Patients with early rheumatoid arthritis who smoke are less likely to respond to treatment with methotrexate and tumor necrosis factor inhibitors: observations from the Epidemiological Investigation of Rheumatoid Arthritis and the Swedish Rheumatology Register cohorts (2011) Arthritis Rheum, 63 (1), pp. 26-36Alberti, K.G., Zimmet, P., Shaw, J., Metabolic syndrome - a new worldwide definition. A Consensus Statement from the International Diabetes Federation (2006) Diabet Med, 23 (5), pp. 469-480(2001) JAMA, 285 (19), pp. 2846-2897. , Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III)Grundy, S.M., Cleeman, J.I., Daniels, S.R., Donato, K.A., Eckel, R.H., Franklin, B.A., Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. [Executive summary] (2005) Circulation, 112 (17), pp. e285-e290Santos, M.J., Fonseca, J.E., Metabolic syndrome, inflammation and atherosclerosis - the role of adipokines in health and in systemic inflammatory rheumatic diseases (2009) Acta Reumatol Port, 34 (4), pp. 590-598Chung, C.P., Oeser, A., Solus, J.F., Avalos, I., Gebretsadik, T., Shintani, A., Prevalence of the metabolic syndrome is increased in rheumatoid arthritis and is associated with coronary atherosclerosis (2008) Atherosclerosis, 196 (2), pp. 756-763Sidiropoulos, P.I., Karvounaris, S.A., Boumpas, D.T., Metabolic syndrome in rheumatic diseases: epidemiology, pathophysiology, and clinical implications (2008) Arthritis Res Ther, 10 (3), p. 207Pereira, R.M., de Carvalho, J.F., Bonfa, E., Metabolic syndrome in rheumatological diseases (2009) Autoimmun Rev, 8 (5), pp. 415-419da Cunha, V., Brenol, C., Brenol, J., Fuchs, S., Arlindo, E., Melo, I., Metabolic syndrome prevalence is increased in rheumatoid arthritis patients and is associated with disease activity (2012) Scand J Rheumatol, 41 (3), pp. 186-191Karvounaris, S.A., Sidiropoulos, P.I., Papadakis, J.A., Spanakis, E.K., Bertsias, G.K., Kritikos, H.D., Metabolic syndrome is common among middle-to-older aged Mediterranean patients with rheumatoid arthritis and correlates with disease activity: a retrospective, crosssectional, controlled, study (2007) Ann Rheum Dis, 66 (1), pp. 28-33Dessein, P.H., Tobias, M., Veller, M.G., Metabolic syndrome and subclinical atherosclerosis in rheumatoid arthritis (2006) J Rheumatol, 33 (12), pp. 2425-2432La Montagna, G., Cacciapuoti, F., Buono, R., Manzella, D., Mennillo, G.A., Arciello, A., Insulin resistance is an independent risk factor for atherosclerosis in rheumatoid arthritis (2007) Diab Vasc Dis Res, 4 (2), pp. 130-135Mottillo, S., Filion, K.B., Genest, J., Joseph, L., Pilote, L., Poirier, P., The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis (2010) J Am Coll Cardiol, 56 (14), pp. 1113-1132da Cunha, V.R., Brenol, C.V., Brenol, J.C., Xavier, R.M., Rheumatoid arthritis and metabolic syndrome (2011) Rev Bras Reumatol, 51 (3), pp. 260-268Toms, T.E., Panoulas, V.F., John, H., Douglas, K.M., Kitas, G.D., Methotrexate therapy associates with reduced prevalence of the metabolic syndrome in rheumatoid arthritis patients over the age of 60 - more than just an anti-inflammatory effect? A cross sectional study (2009) Arthritis Res Ther, 11 (4), pp. R110Bacani, A.K., Gabriel, S.E., Crowson, C.S., Heit, J.A., Matteson, E.L., Noncardiac vascular disease in rheumatoid arthritis: increase in venous thromboembolic events? (2012) Arthritis Rheum, 64 (1), pp. 53-61Matta, F., Singala, R., Yaekoub, A.Y., Najjar, R., Stein, P.D., Risk of venous thromboembolism with rheumatoid arthritis (2009) Thromb Haemost, 101 (1), pp. 134-138Aksu, K., Donmez, A., Keser, G., Inflammation-induced thrombosis: mechanisms, disease associations and management (2012) Curr Pharm Des, 18 (11), pp. 1478-1493Undas, A., Gissel, M., Kwasny-Krochin, B., Gluszko, P., Mann, K.G., Brummel-Ziedins, K.E., Thrombin generation in rheumatoid arthritis: dependence on plasma factor composition (2010) Thromb Haemost, 104 (2), pp. 224-230Bisoendial, R.J., Levi, M., Tak, P.P., Stroes, E.S., The prothrombotic state in rheumatoid arthritis: an additive risk factor for adverse cardiovascular events (2010) Semin Thromb Hemost, 36 (4), pp. 452-457Mameli, A., Barcellona, D., Marongiu, F., Rheumatoid arthritis and thrombosis (2009) Clin Exp Rheumatol, 27 (5), pp. 846-855Liang, K.P., Liang, K.V., Matteson, E.L., McClelland, R.L., Christianson, T.J., Turesson, C., Incidence of noncardiac vascular diseasein rheumatoid arthritis and relationship to extraarticular disease manifestations (2006) Arthritis Rheum, 54 (2), pp. 642-648Davies, R., Galloway, J.B., Watson, K.D., Lunt, M., Symmons, D.P., Hyrich, K.L., Venous thrombotic events are not increased in patients with rheumatoid arthritis treated with anti-TNF therapy: results from the British Society for Rheumatology Biologics Register (2011) Ann Rheum Dis, 70 (10), pp. 1831-1834. , BSRBR Control Centre Consortium, British Society for Rheumatology Biologics RegisterSmitten, A.L., Simon, T.A., Hochberg, M.C., Suissa, S., A meta-analysis of the incidence of malignancy in adult patients with rheumatoid arthritis (2008) Arthritis Res Ther, 10 (2), pp. R45Zintzaras, E., Voulgarelis, M., Moutsopoulos, H.M., The risk of lymphoma development in autoimmune diseases: a meta-analysis (2005) Arch Intern Med, 165 (20), pp. 2337-2344Hemminki, K., Li, X., Sundquist, K., Sundquist, J., Cancer risk in hospitalized rheumatoid arthritis patients (2008) Rheumatology (Oxford), 47 (5), pp. 698-701Kim, Y.J., Shim, J.S., Choi, C.B., Bae, S.C., Mortality and incidence of malignancy in Korean patients with rheumatoid arthritis (2012) J Rheumatol, 39 (2), pp. 226-232Bongartz, T., Sutton, A.J., Sweeting, M.J., Buchan, I., Matteson, E.L., Montori, V., Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials (2006) JAMA, 295 (19), pp. 2275-2285Thompson, A.E., Rieder, S.W., Pope, J.E., Tumor necrosis factor therapy and the risk of serious infection and malignancy in patients with early rheumatoid arthritis: a meta-analysis of randomized controlled trials (2011) Arthritis Rheum, 63 (6), pp. 1479-1485Askling, J., The risk of malignancies in RA patients treated with biologics (2010) Z Rheumatol, 69 (9), pp. 774-779Thomas, E., Symmons, D.P., Brewster, D.H., Black, R.J., Macfarlane, G.J., National study of cause-specific mortality in rheumatoid arthritis, juvenile chronic arthritis, and other rheumatic conditions: a 20 year followup study (2003) J Rheumatol, 30 (5), pp. 958-965Hemminki, K., Liu, X., Ji, J., Sundquist, J., Sundquist, K., Autoimmune disease and subsequent digestive tract cancer by histology (2012) Ann Oncol, 23 (4), pp. 927-933Hellgren, K., Smedby, K.E., Feltelius, N., Baecklund, E., Askling, J., Do rheumatoid arthritis and lymphoma share risk factors? A comparison of lymphoma and cancer risks before and after diagnosis of rheumatoid arthritis (2010) Arthritis Rheum, 62 (5), pp. 1252-1258Miranda-Duarte, A., Kraus-Weisman, A., Granados, J., Vill, A.R., Human leukocyte antigens class II genes are associated with cancer development in the autoimmune rheumatic diseases (2011) Rev Invest Clin, 63 (3), pp. 236-243Strangfeld, A., Hierse, F., Rau, R., Burmester, G.R., Krummel-Lorenz, B., Demary, W., Risk of incident or recurrent malignancies among patients with rheumatoid arthritis exposed to biologic therapy in the German biologics register RABBIT (2010) Arthritis Res Ther, 12 (1), pp. R5Leombruno, J.P., Einarson, T.R., Keystone, E.C., The safety of antitumour necrosis factor treatments in rheumatoid arthritis: meta and exposure-adjusted pooled analyses of serious adverse events (2009) Ann Rheum Dis, 68 (7), pp. 1136-1145Bongartz, T., Warren, F.C., Mines, D., Matteson, E.L., Abrams, K.R., Sutton, A.J., Etanercept therapy in rheumatoid arthritis and the risk of malignancies: a systematic review and individual patient data meta-analysis of randomised controlled trials (2009) Ann Rheum Dis, 68 (7), pp. 1177-1183Askling, J., van Vollenhoven, R.F., Granath, F., Raaschou, P., Fored, C.M., Baecklund, E., Cancer risk in patients with rheumatoid arthritis treated with anti-tumor necrosis factor alpha therapies: does the risk change with the time since start of treatment? (2009) Arthritis Rheum, 60 (11), pp. 3180-3189Dixon, W.G., Watson, K.D., Lunt, M., Mercer, L.K., Hyrich, K.L., Symmons, D.P., Influence of anti-tumor necrosis factor therapy on cancer incidence in patients with rheumatoid arthritis who have had a prior malignancy: results from the British Society for Rheumatology Biologics Register (2010) Arthritis Care Res (Hoboken), 62 (6), pp. 755-763. , [Erratum in: Arthritis Care Res (Hoboken) 201062(10):1514.]Wong, A.K., Kerkoutian, S., Said, J., Rashidi, H., Pullarkat, S.T., Risk of lymphoma in patients receiving antitumor necrosis factor therapy: a meta-analysis of published randomized controlled studies (2012) Clin Rheumatol, 31 (4), pp. 631-636Mariette, X., Matucci-Cerinic, M., Pavelka, K., Taylor, P., van Vollenhoven, R., Heatley, R., Malignancies associated with tumour necrosis factor inhibitors in registries and prospective observational studies: a systematic review and meta-analysis (2011) Ann Rheum Dis, 70 (11), pp. 1895-1904Askling, J., Baecklund, E., Granath, F., Geborek, P., Fored, M., Backlin, C., Anti-tumour necrosis factor therapy in rheumatoid arthritis and risk of malignant lymphomas: relative risks and time trends in the Swedish Biologics Register (2009) Ann Rheum Dis, 68 (5), pp. 648-653Simon, T.A., Smitten, A.L., Franklin, J., Askling, J., Lacaille, D., Wolfe, F., Malignancies in the rheumatoid arthritis abatacept clinical development programme: an epidemiological assessment (2009) Ann Rheum Dis, 68 (12), pp. 1819-1826Slimani, S., Lukas, C., Combe, B., Morel, J., Rituximab in rheumatoid arthritis and the risk of malignancies: report from a French cohort (2011) Joint Bone Spine, 78 (5), pp. 484-487Forsblad D'Elia, H., Larsen, A., Waltbrand, E., Kvist, G., Mellström, D., Saxne, T., Radiographic joint destruction in postmenopausal rheumatoid arthritis is strongly associated with generalized osteoporosis (2003) Ann Rheum Dis, 62 (7), pp. 617-623van Staa, T.P., Geusens, P., Bijlsma, J.W., Leufkens, H.G., Cooper, C., Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis (2006) Arthritis Rheum, 54 (10), pp. 3104-3112Vis, M., Haavardsholm, E.A., Bøyesen, P., Haugeberg, G., Uhlig, T., Hoff, M., High incidence of vertebral and non-vertebral fractures in the OSTRA cohort study: a 5-year follow-up study in postmenopausal women with rheumatoid arthritis (2011) Osteoporos Int, 22 (9), pp. 2413-2419Edwards, C.J., Williams, E., The role of interleukin-6 in rheumatoid arthritis-associated osteoporosis (2010) Osteoporos Int, 21 (8), pp. 1287-1293Daoussis, D., Andonopoulos, A.P., Liossis, S.N., Wnt pathway and IL-17: novel regulators of joint remodeling in rheumatic diseases. Looking beyond the RANK-RANKL-OPG axis (2010) Semin Arthritis Rheum, 39 (5), pp. 369-383Yuan, F.L., Li, X., Lu, W.G., Zhao, Y.Q., Li, C.W., Li, J.P., Type 17 T-helper cells might be a promising therapeutic target for osteoporosis (2012) Mol Biol Rep, 39 (1), pp. 771-774Kanis, J.A., Borgstrom, F., De Laet, C., Johansson, H., Johnell, O., Jonsson, B., Assessment of fracture risk (2005) Osteoporos Int, 16 (6), pp. 581-589Broy, S.B., Tanner, S.B., Official Positions for FRAX® clinical regarding rheumatoid arthritis from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX® (2011) J Clin Densitom, 14 (3), pp. 184-189. , FRAX® Position Development Conference MembersTourinho, T.F., Capp, E., Brenol, J.C., Stein, A., Physical activity prevents bone loss in premenopausal women with rheumatoid arthritis: a cohort study (2008) Rheumatol Int, 28 (10), pp. 1001-1007de Jong, Z., Munneke, M., Lems, W.F., Zwinderman, A.H., Kroon, H.M., Pauwels, E.K., Slowing of bone loss in patients with rheumatoid arthritis by long-term high-intensity exercise: results of a randomized, controlled trial (2004) Arthritis Rheum, 50 (4), pp. 1066-1076Papaioannou, A., Morin, S., Cheung, A.M., Atkinson, S., Brown, J.P., Feldman, S., Scientific Advisory Council of Osteoporosis Canada. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary (2010) CMAJ, 182 (17), pp. 1864-1873Grossman, J.M., Gordon, R., Ranganath, V.K., Deal, C., Caplan, L., Chen, W., American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis (2010) Arthritis Care Res (Hoboken), 62 (11), pp. 1515-1526Mota, L.M.H., Cruz, B.A., Brenol, C.V., Pereira, I.A., Fronza, L.S., Bertolo, M.B., 2011 Consensus of the Brazilian Society of Rheumatology for diagnosis and early assessment of rheumatoid arthritis (2011) Rev Bras Reumatol, 51 (3), pp. 199-219da Mota, L.M., Cruz, B.A., Brenol, C.V., Pereira, I.A., Rezende-Fronza, L.S., Bertolo, M.B., 2012 Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthritis (2012) Rev Bras Reumatol, 52 (2), pp. 152-174