title: [Effect of tumour necrosis factor α blockade on bone metabolism in chronic inflammatory joint diseases].
abstract: OBJECTIVE
  To evaluate the effect of anti-TNF treatments on bone mineral density (BMD), bone remodelling markers (BRM) and receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) in patients with chronic inflammatory joint diseases.
  
  
  METHODS
  A longitudinal prospective study was performed under clinical practice conditions on 31 patients diagnosed of rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis who had received treatment with anti-TNF alpha drugs for one year. BMD, OPG and RANKL soluble form (sRANKL) were studied at the onset and end of the study. During the study (0, 3, 6, 9 and 12 month), disease activity (SDAI, BASDAI and CRP), functional capacity (HAQ, BASFI), BRM and vitamin D were studied.
  
  
  RESULTS
  BMD was not modified after one year of treatment. The patients who took corticosteroids had a mean bone mass loss of 3% in the lumbar spine (±1.6, P=.02). In regards to the BRM, did not experience significant changes over the course of the study. Disease activity, both SDAI (P=.002) and BASDAI (P=.002), decreased. OPG was maintained without changes during the year of treatment while both the sRANKL (0.28±0.22, P=.013) and sRANKL/OPG ratio significantly decreased (0.04±0.03, P=.031).
  
  
  CONCLUSIONS
  The patients being treated with anti-TNF did not present with a significant loss of DMO during the study (one year), at the same time experiencing an improvement in disease activity. This protection has been clearer in the responding patients.
authors.affiliation: Servicio de Reumatología, Hospital Clínico Virgen de la Victoria, Málaga, España. Electronic address: fjaguilarrey@yahoo.es.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Aguilar Del Rey
authors.affiliation: Servicio de Reumatología, Hospital Clínico Virgen de la Victoria, Málaga, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: García Portales
authors.affiliation: Servicio de Reumatología, Hospital Clínico Virgen de la Victoria, Málaga, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Haro Liger
authors.affiliation: Servicio de Reumatología, Hospital Clínico Virgen de la Victoria, Málaga, España.
authors.forename: José
authors.initials: J
authors.lastname: Rodríguez Andreu
authors.affiliation: Servicio de Reumatología, Hospital Clínico Virgen de la Victoria, Málaga, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Casals Sánchez
authors.affiliation: Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud (FIMABIS), Málaga, España.
authors.forename: Rita
authors.initials: R
authors.lastname: Pérez González
mesh_terms: D000068879:Adalimumab / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000378:metabolism; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling / Q000187:drug effects*; D002908:Chronic Disease; D000068800:Etanercept / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000494:pharmacology / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000378:metabolism; D011446:Prospective Studies; D053245:RANK Ligand / Q000378:metabolism; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000378:metabolism; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D053244:Osteoprotegerin; D053245:RANK Ligand; C439524:TNF protein, human; C506030:TNFRSF11B protein, human; C505688:TNFSF11 protein, human; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
keywords: Anti-factor de necrosis tumoral; Anti-tumor necrosis factor; Bone mineral density; Bone remodelling markers; Chronic inflammatory joint disease; Densidad mineral ósea; Enfermedad inflamatoria articular crónica; Ligando del receptor activador del factor nuclear kappa-beta; Marcadores de remodelado óseo; Osteoprotegerin; Osteoprotegerina; Receptor activator of nuclear kappa-beta