Effects of anti-tumor necrosis factor α agents on bone.
OBJECTIVE
Tumor necrosis factor (TNF) inhibitors are effective for achieving disease control in several inflammatory diseases. Although anti-TNF agents can inhibit bone loss in vitro, their role in the prevention of clinically relevant outcomes such as osteoporosis and fractures has not been clearly established.


RESULTS
There are many studies of the effects of TNF inhibitors on markers of bone turnover; however, few have measured bone mineral density (BMD) or fractures. Most of these studies have small sample sizes and a minority had a placebo control group. Overall these studies suggest that the antiresorptive effects of anti-TNF therapy are related to control of disease activity.


CONCLUSIONS
The antiresorptive effects of TNF inhibitors are likely related to their anti-inflammatory properties. Studies to date have not demonstrated any advantages of TNF inhibitors over traditional nonbiologic therapies in the prevention of bone loss and fractures.
Vanderbilt University School of Medicine, Nashville Tennessee, USA. vivian.k.kawai@vanderbilt.edu
Vivian K
VK
Kawai
C Michael
CM
Stein
Daniel S
DS
Perrien
Marie R
MR
Griffin
D001172:Arthritis, Rheumatoid / Q000150:complications / Q000276:immunology / Q000628:therapy; D001847:Bone Diseases / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D016723:Bone Remodeling / Q000276:immunology; D006801:Humans; D010006:Osteoblasts / Q000276:immunology; D010010:Osteoclasts / Q000276:immunology; D015398:Signal Transduction / Q000276:immunology; D025242:Spondylarthropathies / Q000150:complications / Q000276:immunology / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D014409:Tumor Necrosis Factor-alpha