Short-Term Effects of TNF Inhibitors on Bone Turnover Markers and Bone Mineral Density in Rheumatoid Arthritis.

Abstract

TNFα inhibitors (TNFαI) exert positive effects on disease activity in rheumatoid arthritis (RA). Bone involvement is a major determinant of functional impairment in this disease. Here we investigated the short-term effects of TNFαI therapy on bone metabolism and density. We studied 54 patients with RA starting a TNFαI biologic drug, in whom any factor known to interfere with bone metabolism was excluded or rigorously accounted for. We measured at baseline and after 6-month therapy bone turnover markers: N-propeptide of type I collagen (P1NP), and bone alkaline phosphates for bone formation and serum C-terminal telopeptide of type I collagen (CTX) for bone resorption. We also evaluated bone mineral density (BMD) at hip and lumbar by dual-energy X-ray absorptiometry. All bone markers rose significantly and these changes were not dependent on steroid dosage. A significant decrease in femoral neck BMD was also observed. These results indicate that TNFαI therapy in RA over 6 months is associated with an early increase in bone turnover and a decline in hip BMD.

• Authors: Giovanni Orsolini, Giovanni Adami, Silvano Adami, Ombretta Viapiana, Luca Idolazzi, Davide Gatti, Maurizio Rossini
• Journal: Calcified tissue international (Calcif Tissue Int) Vol. 98 Issue 6 Pg. 580-5 (Jun 2016) ISSN: 1432-0827 [Electronic] United States
• PMID: 26887973 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antirheumatic Agents
• Tumor Necrosis Factor-alpha
• golimumab
• Infliximab
• Adalimumab
• Etanercept
• Certolizumab Pegol

Topics

• Adalimumab (therapeutic use)
• Adult
• Aged
• Antibodies, Monoclonal (therapeutic use)
• Antirheumatic Agents (therapeutic use)
• Arthritis, Rheumatoid (drug therapy)
• Bone Density (drug effects)
• Bone Remodeling (drug effects)
• Certolizumab Pegol (therapeutic use)
• Etanercept (therapeutic use)
• Female
• Humans
• Infliximab (therapeutic use)
• Male
• Middle Aged
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)