title: 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.affiliation: Rheumatology Section, Department of Medicine, University of Verona, Piazzale Ludovico Scuro, Policlinico G.B Rossi, 37134, Verona, Italy. giovanniorsolini@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Orsolini
authors.affiliation: Rheumatology Section, Department of Medicine, University of Verona, Piazzale Ludovico Scuro, Policlinico G.B Rossi, 37134, Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Adami
authors.affiliation: Rheumatology Section, Department of Medicine, University of Verona, Piazzale Ludovico Scuro, Policlinico G.B Rossi, 37134, Verona, Italy.
authors.forename: Silvano
authors.initials: S
authors.lastname: Adami
authors.affiliation: Rheumatology Section, Department of Medicine, University of Verona, Piazzale Ludovico Scuro, Policlinico G.B Rossi, 37134, Verona, Italy.
authors.forename: Ombretta
authors.initials: O
authors.lastname: Viapiana
authors.affiliation: Rheumatology Section, Department of Medicine, University of Verona, Piazzale Ludovico Scuro, Policlinico G.B Rossi, 37134, Verona, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Idolazzi
authors.affiliation: Rheumatology Section, Department of Medicine, University of Verona, Piazzale Ludovico Scuro, Policlinico G.B Rossi, 37134, Verona, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Gatti
authors.affiliation: Rheumatology Section, Department of Medicine, University of Verona, Piazzale Ludovico Scuro, Policlinico G.B Rossi, 37134, Verona, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rossini
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling / Q000187:drug effects*; D000068582:Certolizumab Pegol / Q000627:therapeutic use; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept; D000068582:Certolizumab Pegol
keywords: Anti-TNF alpha; Bone formation; Bone mineral density; Bone resorption; Bone turnover markers