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Tacrolimus treatment increases bone formation in patients with rheumatoid arthritis

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Abstract

Tacrolimus is a calcineurin inhibitor, and it is used for the treatment of rheumatoid arthritis (RA). It works by inhibiting nuclear factor of activated T cells and inducting immunosuppression. This study aims to evaluate the influence of tacrolimus on the bone metabolism of patients with RA. Twenty-eight RA patients in three centers received tacrolimus 3 mg once daily for 24 weeks. Blood samples for evaluating bone metabolism and cytokines were collected at Weeks 0 and 24. We measured the serum C-telopeptide of type I collagen (sCTx-I), osteocalcin and inflammatory cytokines. We analyzed the data using the Kruskal–Wallis test and Spearman’s correlation. IL-2 and IL-6 were significantly decreased after the administration of tacrolimus (p = 0.027 and p = 0.024). There was no significant difference in the serum level of sCTx-I before and after treatment. The level of serum osteocalcin at Week 24 was significantly increased compared to the level at Week 0 (p = 0.002). The increase of osteocalcin was correlated with the reductions of IL-2 and IFN-γ (r = 0.405, p = 0.033 and r = 0.380, p = 0.046, respectively). Tacrolimus treatment increased bone formation markers in RA patients. This suggests that tacrolimus may play a role to inhibit bone erosion by increasing bone formation as well as improving the clinical symptoms of RA.

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Acknowledgments

This study was supported by a grant of the Korea Healthcare technology R&D project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (A084794).

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, South Korea

    Kwi Young Kang

  2. Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, #505, Banpo-Dong, Seocho-Gu, Seoul, South Korea

    Ji Hyeon Ju, Ho-Youn Kim & Sung-Hwan Park

  3. Division of Rheumatology, Department of Internal Medicine, Seoul National University, Seoul, South Korea

    Yeong Wook Song

  4. Division of Rheumatology, Department of Internal Medicine, Hanyang University Hospital, Seoul, South Korea

    Dae-Hyun Yoo

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  1. Kwi Young Kang
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  2. Ji Hyeon Ju
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Correspondence to Sung-Hwan Park.

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Kang, K.Y., Ju, J.H., Song, Y.W. et al. Tacrolimus treatment increases bone formation in patients with rheumatoid arthritis. Rheumatol Int 33, 2159–2163 (2013). https://doi.org/10.1007/s00296-012-2370-z

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  • DOI: https://doi.org/10.1007/s00296-012-2370-z

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