Rapid improvement of bone metabolism after infliximab treatment in Crohn's disease.
BACKGROUND
Crohn's disease is associated with low bone mineral density and altered bone metabolism.


OBJECTIVE
To assess the evolution of bone metabolism in Crohn's disease patients treated with infliximab.


METHODS
We studied 71 Crohn's disease patients treated for the first time with infliximab for refractory Crohn's disease. Biochemical markers of bone formation (type-I procollagen N-terminal propeptide, bone-specific alkaline phosphatase, osteocalcin) and of bone resorption (C-telopeptide of type-I collagen) were measured in the serum before and 8 weeks after infliximab therapy and compared with values in a matched healthy control group.


RESULTS
Eight weeks after treatment with infliximab, a normalization of bone markers was observed with a median increase in formation markers of 14-51% according to marker and a lower but significant decrease in resorption marker (median 11%). A clinically relevant increase in bone formation markers was present in 30-61% of patients according to the marker. A clinically relevant decrease in C-telopeptide of type-I collagen was present in 38% of patients. No association was found with any tested demographic or clinical parameter.


CONCLUSIONS
Infliximab therapy in Crohn's disease may rapidly influence bone metabolism by acting either on bone formation or bone resorption. This improvement seems to be independent of clinical response to infliximab.
Franchimont
N
N
Rheumatology Department, CHU Liège, Belgium.
Putzeys
V
V
Collette
J
J
Vermeire
S
S
Rutgeerts
P
P
De Vos
M
M
Van Gossum
A
A
Franchimont
D
D
Fiasse
R
R
Pelckmans
P
P
Malaise
M
M
Belaiche
J
J
Louis
E
E
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D001862:Bone Resorption / Q000209:etiology / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D003424:Crohn Disease / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology
D000911:Antibodies, Monoclonal; D015415:Biomarkers; D005765:Gastrointestinal Agents; D000069285:Infliximab