title: Anti-tumor Necrosis Factor Therapy Increased Spine and Femoral Neck Bone Mineral Density of Patients with Active Ankylosing Spondylitis with Low Bone Mineral Density.
abstract: OBJECTIVE
  To evaluate the effect of anti-tumor necrosis factor (TNF) therapy on bone mineral density (BMD) in patients with active ankylosing spondylitis (AS) with low BMD.
  
  
  METHODS
  Eighty-nine patients with active AS with low BMD were randomly divided into either a study group or a control group. The study group received etanercept (50 mg/week) or adalimumab (40 mg/2 week) subcutaneously for 1 year. BMD of lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry, and bone turnover markers serum C telopeptide of type-I collagen (sCTX) and serum procollagen type-I N propeptide (PINP) were detected by ELISA at baseline and at end of study.
  
  
  RESULTS
  After 1 year, compared with baseline, there was a significant increase in spine and femoral neck BMD by a mean ± SD of 14.9% ± 15.6% (p < 0.0001) and 4.7% ± 7.9% (p < 0.0001) in the study group. In the control group, there was a significant decrease in spine and femoral neck BMD by a mean ± SD of -8.6% ± 9.7% (p < 0.0001) and -9.8% ± 11.5% (p < 0.0001). Compared with baseline, sCTX was significantly decreased in the study group (-40% at 1 yr, p < 0.0001), but bone-specific alkaline phosphatase and PINP increased (45.6%, p < 0.0001 and 30.8%, p < 0.0001, respectively).
  
  
  CONCLUSIONS
  In patients with active AS with low BMD, the spine and femoral neck BMD increased after anti-TNF therapy for 1 year, and it was accompanied by a significant decrease in bone resorption markers and an increase in bone formation markers.
authors.affiliation: From Sun Yat-sen University, Guangzhou; Department of Rheumatology, General Hospital of Ningxia Medical University, Yinchuan, China.H. Li, PhD Candidate, Sun Yat-sen University, and Department of Rheumatology, General Hospital of Ningxia Medical University; Q. Li, PhD; X. Chen, Department of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University; C. Ji, Department of Rheumatology, General Hospital of Ningxia Medical University; J. Gu, Third Affiliated Hospital of Sun Yat-sen University.
authors.forename: Haibo
authors.initials: H
authors.lastname: Li
authors.affiliation: From Sun Yat-sen University, Guangzhou; Department of Rheumatology, General Hospital of Ningxia Medical University, Yinchuan, China.H. Li, PhD Candidate, Sun Yat-sen University, and Department of Rheumatology, General Hospital of Ningxia Medical University; Q. Li, PhD; X. Chen, Department of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University; C. Ji, Department of Rheumatology, General Hospital of Ningxia Medical University; J. Gu, Third Affiliated Hospital of Sun Yat-sen University.
authors.forename: Qiuxia
authors.initials: Q
authors.lastname: Li
authors.affiliation: From Sun Yat-sen University, Guangzhou; Department of Rheumatology, General Hospital of Ningxia Medical University, Yinchuan, China.H. Li, PhD Candidate, Sun Yat-sen University, and Department of Rheumatology, General Hospital of Ningxia Medical University; Q. Li, PhD; X. Chen, Department of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University; C. Ji, Department of Rheumatology, General Hospital of Ningxia Medical University; J. Gu, Third Affiliated Hospital of Sun Yat-sen University.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: From Sun Yat-sen University, Guangzhou; Department of Rheumatology, General Hospital of Ningxia Medical University, Yinchuan, China.H. Li, PhD Candidate, Sun Yat-sen University, and Department of Rheumatology, General Hospital of Ningxia Medical University; Q. Li, PhD; X. Chen, Department of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University; C. Ji, Department of Rheumatology, General Hospital of Ningxia Medical University; J. Gu, Third Affiliated Hospital of Sun Yat-sen University.
authors.forename: Chen
authors.initials: C
authors.lastname: Ji
authors.affiliation: From Sun Yat-sen University, Guangzhou; Department of Rheumatology, General Hospital of Ningxia Medical University, Yinchuan, China.H. Li, PhD Candidate, Sun Yat-sen University, and Department of Rheumatology, General Hospital of Ningxia Medical University; Q. Li, PhD; X. Chen, Department of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University; C. Ji, Department of Rheumatology, General Hospital of Ningxia Medical University; J. Gu, Third Affiliated Hospital of Sun Yat-sen University. gujieruo@163.com.
authors.forename: Jieruo
authors.initials: J
authors.lastname: Gu
mesh_terms: D000068879:Adalimumab / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D000068800:Etanercept / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013131:Spine / Q000000981:diagnostic imaging / Q000187:drug effects*; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab; D000068800:Etanercept
keywords: ANKYLOSING SPONDYLITIS; ANTI-TNF THERAPY; BONE MINERAL DENSITY; BONE TURNOVER MARKER