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We read with great interest the article “Baseline serum RANKL levels may serve to predict remission in patients with rheumatoid arthritis treated with TNF antagonists” by Gonzalez-Alvaro, recently published in Annals of Rheumatic Diseases.1 Other reports have previously shown increased serum levels of RANKL (receptor activator for nuclear factor κB ligand), as well as of osteoprotegerin (OPG), in patients affected by rheumatoid arthritis (RA), and the upregulation of OPG has been usually interpreted as a compensatory mechanism to limit bone erosion due to RANKL activity.2–4 In addition, Gonzalez-Alvaro et al stated that low serum levels of baseline RANKL and the RANKL:OPG …
Competing interests: None.
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