Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NF B ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis
- 1 November 2006
- journal article
- clinical trial
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 65 (11), 1495-1499
- https://doi.org/10.1136/ard.2005.044198
Abstract
To examine whether treatment with anti-tumour necrosis factor (TNF) alpha prevents loss of bone mineral density (BMD) at the spine and hip (generalised) and in the hands (local) of patients with rheumatoid arthritis, and to study the changes in markers of bone metabolism, including receptor activator of the NFkappaB ligand (RANKL) and osteoprotegerin (OPG), during anti-TNF treatment. 102 patients with active rheumatoid arthritis, who were treated with infliximab during 1 year, were included in this open cohort study. The BMD of the spine and hip (dual x ray absorptiometry) and hands dual x ray radiogrammetry was measured before the start of treatment and after 1 year. Changes in osteocalcin formation, beta-isomerised carboxy terminal telopeptide of type 1 collagen (beta-CTx, resorption), RANKL and OPG were determined at 0, 14, 30 and 46 weeks. The BMD of the spine and hip was unchanged during treatment with infliximab, whereas BMD of the hand decreased significantly by 0.8% (p<0.01). The BMD of the hip in patients with a good European League Against Rheumatism response showed a favourable change compared with patients not achieving such a response. Serum beta-CTx and RANKL were both considerably decreased compared with baseline at all time points. The decrease in beta-CTx was associated with the decrease in Disease Activity Score of 28 joints and C reactive protein during the 0-14 weeks interval. In patients with rheumatoid arthritis treated with infliximab, spine and hip bone loss is arrested, whereas metacarpal cortical hand bone loss is not stopped. The outcome of the study also supports a relationship between clinical response, in terms of reduced inflammatory activity, and changes in bone loss of the spine, hip and hands.Keywords
This publication has 28 references indexed in Scilit:
- Hand cortical bone mass and its associations with radiographic joint damage and fractures in 50-70 year old female patients with rheumatoid arthritis: cross sectional Oslo-Truro-Amsterdam (OSTRA) collaborative studyAnnals Of The Rheumatic Diseases, 2004
- Predicting erosive disease in rheumatoid arthritis. A longitudinal study of changes in bone density using digital X-ray radiogrammetry: a pilot studyRheumatology, 2004
- Interleukin-1β and tumor necrosis factor-α, but not interleukin-6, stimulate osteoprotegerin ligand gene expression in human osteoblastic cellsBone, 1999
- Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor ? monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritisArthritis & Rheumatism, 1998
- Should we look for osteoporosis in patients with rheumatoid arthritis?Annals Of The Rheumatic Diseases, 1998
- Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritisThe Lancet, 1997
- Changes in (markers of) bone metabolism during high dose corticosteroid pulse treatment in patients with rheumatoid arthritis.Annals Of The Rheumatic Diseases, 1996
- Development and validation of the european league against rheumatism response criteria for rheumatoid arthritis: Comparison with the preliminary american college of rheumatology and the world health organization/international league against rheumatism criteriaArthritis & Rheumatism, 1996
- Rheumatoid arthritis and bone mineral density in elderly womenJournal of Bone and Mineral Research, 1995
- The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis & Rheumatism, 1988