In light of the different mechanisms through which RA patients may experience a more accelerated bone loss and considering how the presence of ACPAs can represent an additional risk factor, probably at least in part due to their indirect action in the RANK-RANKL system, together with the well-known role of these autoantibodies in inducing erosions, some Authors have speculated on the possibility of a preferential choice of denosumab in the subgroup of seropositive patients [25,26,27,28]. This evidence concerns the gene TNFRSF11A and rheumatoid arthritis.