Tomizawa T, et al. - Via a prospective longitudinal study in 379 subjects with rheumatoid arthritis (RA, a predominantly inflammatory arthritis and a well-known reason of secondary osteoporosis), out of which 329 of whom underwent an assessment of blood and urine biomarkers together with a measurement of bone mineral density (BMD) in the lumbar spine, proximal femur, and distal forearm, experts intended to recognize biomarkers predictive of BMD change at three anatomical sites in subjects with RA. At baseline, 63.2, 21.3, and 3.2, respectively, were the averages of age, body mass index and disease activity score in 28 joints (DAS28). The annual BMD variation was significantly correlated with the use of steroid, bisphosphonate (BP) or vitamin D (VitD), and serum homocysteine; DAS28, the use of BP or VitD, C-reactive protein, and anti-cyclic citrullinated peptide antibody; and the dosage of MTX, the use of BP or VitD, and serum tartrate-resistant acid phosphatase 5b in the lumbar spine, in the proximal femur, and in the distal forearm, respectively. Hence, at each anatomical site, predictive biomarkers for BMD change in RA subjects varied. in order to prevent fractures for RA subjects, clinicians should treat each anatomical site with various markers and prescribe osteoporosis drugs.