Effects of 1-year anti-TNF-α therapies on bone mineral density and bone biomarkers in rheumatoid arthritis and ankylosing spondylitis

被引：77

作者：

Gulyas, Katalin ^{[1
,2
]}

Horvath, Agnes ^{[1
]}

Vegh, Edit ^{[1
]}

Pusztai, Anita ^{[1
]}

Szentpetery, Agnes ^{[1
,3
,4
]}

Petho, Zsofia ^{[1
]}

Vancsa, Andrea ^{[1
]}

Bodnar, Nora ^{[1
]}

Csomor, Peter ^{[1
]}

Hamar, Attila ^{[1
]}

Bodoki, Levente ^{[1
]}

Bhattoa, Harjit Pal ^{[5
]}

Juhasz, Balazs ^{[6
]}

Nagy, Zoltan ^{[1
]}

Hodosi, Katalin ^{[1
]}

Karosi, Tamas ^{[7
]}

FitzGerald, Oliver ^{[4
]}

Szucs, Gabriella ^{[1
]}

Szekanecz, Zoltan ^{[1
]}

Szamosi, Szilvia ^{[1
]}

Szanto, Sandor ^{[1
,2
]}

机构：

[1] Univ Debrecen, Fac Med, Dept Internal Med, Div Rheumatol, Nagyerde str 98, H-4032 Debrecen, Hungary

[2] Dept Sports Med, Debrecen, Hungary

[3] Uppsala Univ Hosp, Dept Rheumatol, Uppsala, Sweden

[4] Univ Coll Dublin, St Vincents Univ Hosp, Conway Inst BioMol Res, Dept Rheumatol, Dublin, Ireland

[5] Univ Debrecen, Fac Med, Dept Lab Med, Debrecen, Hungary

[6] Univ Debrecen, Fac Med, Dept Oncol, Debrecen, Hungary

[7] Borsod Cty Teaching Hosp, Dept Otolaryngol, Miskolc, Hungary

来源：

CLINICAL RHEUMATOLOGY | 2020年 / 39卷 / 01期

关键词：

Biologics; Bone loss; DKK-1; Erosion; JAK inhibitors; Osteoporosis; Osteoprotegerin; RANKL; Rheumatoid arthritis; Sclerostin; Spondyloarthritis; Syndesmophyte; CATHEPSIN-K; RADIOLOGICAL PROGRESSION; TURNOVER MARKERS; DISEASE-ACTIVITY; SERUM-LEVELS; METABOLISM; INFLIXIMAB; OSTEOPROTEGERIN; INHIBITION; DICKKOPF-1;

D O I：

10.1007/s10067-019-04771-3

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objectives Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with generalized and localized bone loss. We conducted a comprehensive study using imaging (dual-energy X-ray absorptiometry, DXA) and laboratory biomarkers in order to determine bone health and to study the effects of anti-tumor necrosis factor (TNF) biologics in RA and AS. Patients and methods Thirty-six RA and 17 AS patients undergoing 1-year etanercept (ETN) or certolizumab-pegol (CZP) therapy were studied. Bone density was assessed by DXA at baseline and after 12 months. Serum C-reactive protein (CRP), calcium, phosphate, parathyroid hormone (PTH), vitamin D3, osteocalcin, procollagen type I N-propeptide (P1NP), C-terminal telopeptide (beta CTX), osteoprotegerin, sclerostin (SOST), Dickkopf-1 (DKK-1), soluble receptor activator nuclear kappa B ligand (sRANKL), and cathepsin K (cathK) levels were determined at baseline and after 6 and 12 months. Results TNF-alpha inhibition was clinically effective. Anti-TNF-alpha halted further bone loss over 1 year. In general, anti-TNF therapy significantly increased P1NP, SOST levels, and the P1NP/beta CTX ratios, while decreased DKK-1 and CathK production at different time points in most patient subsets. In the full cohort and in RA, baseline and/or 12-month bone mineral density (BMD) at multiple sites exerted inverse relationships with CRP and beta CTX, and positive correlation with SOST. In AS, L2-4 BMD after 1-year biologic therapy inversely correlated with baseline beta CTX, while femoral neck BMD rather showed inverse correlations with CRP. Conclusions Anti-TNF therapy slowed down generalized bone loss, in association with clinical improvements, in both diseases. TNF blockade may enhance bone formation and suppress joint destruction. Anti-TNF therapy may act inversely on DKK-1 and SOST. Independent predictors of BMD were SOST and beta CTX in RA, whilst CRP in AS.

引用

页码：167 / 175

页数：9

共 41 条

[1]

Effect of Tumor Necrosis Factor Alpha Inhibition on Bone Density and Turnover Markers in Patients with Rheumatoid Arthritis and Spondyloarthropathy [J].