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Short-Term Effects of TNF Inhibitors on Bone Turnover Markers and Bone Mineral Density in Rheumatoid Arthritis

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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.

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Authors and Affiliations

  1. Rheumatology Section, Department of Medicine, University of Verona, Piazzale Ludovico Scuro, Policlinico G.B Rossi, 37134, Verona, Italy

    Giovanni Orsolini, Giovanni Adami, Silvano Adami, Ombretta Viapiana, Luca Idolazzi, Davide Gatti & Maurizio Rossini

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  1. Giovanni Orsolini
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  2. Giovanni Adami
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  3. Silvano Adami
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  4. Ombretta Viapiana
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  5. Luca Idolazzi
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  7. Maurizio Rossini
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Correspondence to Giovanni Orsolini.

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Conflict of Interest

Giovanni Orsolini, Giovanni Adami, Silvano Adami, Ombretta Viapiana, Luca Idolazzi, Davide Gatti and Maurizio Rossini have no conflict of interest to declare.

Human and Animal Rights and Informed Consent

The study was approved by the institutional review board of the Medical School of Verona and performed according to the Helsinki declaration. All patients provided written informed consent for their participation in the study.

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Orsolini, G., Adami, G., Adami, S. et al. Short-Term Effects of TNF Inhibitors on Bone Turnover Markers and Bone Mineral Density in Rheumatoid Arthritis. Calcif Tissue Int 98, 580–585 (2016). https://doi.org/10.1007/s00223-016-0114-x

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  • DOI: https://doi.org/10.1007/s00223-016-0114-x

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