Effect of tumor necrosis factor alpha inhibition on bone density and turnover markers in patients with rheumatoid arthritis and spondyloarthropathy
Barnabe C et al. - Anti-TNFα therapies are reported to have beneficial effects on bone density and bone turnover markers. However, retrieved studies in this review were heterogeneous with regards to patients studied, underlying risks for osteoporosis, and supplemental therapy, which may limit the findings of the true effect of anti-TNFα therapy on bone.Methods- Review of current literature reporting on:
- Effect of anti-TNFα on bone density as measured by DEXA at the lumbar spine and hip
- Effect on markers of bone turnover and resorption, in pts using anti-TNFα for rheumatic disease indications
- PubMed search, as well as manual search of related articles and references of articles retrieved
- Studies pertaining to the effect of anti-TNFα therapy on BMD and bone turnover markers were included
Results- In RA, 4 studies (238 pts) showed a stabilization or increase of BMD at the spine or hip with only 1 negative study in 48 pts
- In spondyloarthopathies, 3 studies (75 pts) all demonstrated an increase in BMD at the lumbar spine and at the hip
- Changes in markers of bone formation and bone resorption were heterogeneous but in general represented a modest increase in formation and decline in resorption
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