title: Infliximab therapy improves the bone metabolism in fistulizing Crohn's disease.
abstract: BACKGROUND
  Tumor necrosis factor-alpha (TNF-alpha) plays a pivotal role in the pathogenesis of inflammatory bowel diseases and bone resorption as well. Limited data exist about the effect of anti-TNF-alpha infliximab on bone metabolism in inflammatory-type Crohn's disease (CD).
  
  
  OBJECTIVE
  Our aim was to evaluate the effect of infliximab treatment on rapid changes of bone metabolism in fistulizing CD patients.
  
  
  METHODS
  27 patients with fistulizing CD were treated with three series of infliximab. Serum osteocalcin (OC) and beta-CrossLaps (bCL) were measured before administration of each infliximab infusion. 54 patients with inactive CD were controls.
  
  
  RESULTS
  In treated patients, there were significant differences in bCL concentrations on days 0 and 14 (p < 0.01) and days 0 and 42 (p < 0.05). OC levels increased significantly between day 0 and 42 (p < 0.05). The values of bCL and OC of control groups differed from serum levels in active patients before the treatment, but not on day 42. Bone markers improved significantly in responder patients, but not in non-responders.
  
  
  CONCLUSIONS
  The beneficial effect of infliximab to the bone metabolism is more expressive in patients whose fistulizing disease improves with this therapy. Our results suggest that TNF-alpha has an important role in the alteration of bone metabolism in fistulizing CD patients.
authors.affiliation: Semmelweis University, Second Department of Internal Medicine, Budapest, Hungary. mihpal@yahoo.co.uk
authors.forename: Pal
authors.initials: P
authors.lastname: Miheller
authors.forename: Gyorgyi
authors.initials: G
authors.lastname: Muzes
authors.forename: Tamas
authors.initials: T
authors.lastname: Zagoni
authors.forename: Miklos
authors.initials: M
authors.lastname: Toth
authors.forename: Karoly
authors.initials: K
authors.lastname: Racz
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Tulassay
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D007412:Intestinal Fistula / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab