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The receptor activator of nuclear factor kappa- ligand (RANKL)/RANK pathway drives osteoclastogenesis, leading to bone erosion in 80% of untreated patients within 2 years (13)

(People with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 shouldn't take these medications.) GLP-1 agonists also have a risk of causing other rare but dangerous side effects, like pancreatitis and gallbladder disease

Statements Author contributions MS: Conceptualization, Writing review & editing, Data curation, Formal Analysis, Methodology, Supervision, Writing original draft

The article also states that a provider medical evaluation is mandatory before initiation, and that eligibility generally starts at a BMI of 30, or 27 with weight-related conditions

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Some patients notice that pain flares decrease as weight stabilizes, while others require imaging or surgical evaluation