Ann Rheum Dis. Published Online First: 13 April 2008. doi:10.1136/ard.2008.091611
Extended Report |
Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss?
1 Academic Medical Center/University of Amsterdam, Netherlands
2 academic medical center/university of Amsterdam, Netherlands
* To whom correspondence should be addressed. E-mail: p.p.tak{at}amc.uva.nl.
Accepted 31 March 2008
Abstract
Objective: To explore the effects of anti-TNF
antibody therapy on bone mineral density (BMD) of the lumbar spine and femur neck in patients with rheumatoid arthritis (RA).
Methods 50 patients with active RA (DAS28
3.2) who started adalimumab (40 mg subcutaneously / 2 weeks) were included in an open label prospective study. All patients used stable methotrexate and were allowed to use prednisone ("T 10 mg/day). The BMD of the lumbar spine and femur neck was measured before, and one year after start of treatment.
Results: Both disease activity at baseline (DAS28) and disease duration were inversely correlated with femoral neck BMD and lumbar spine BMD (P < 0.05). Mean BMD of both lumbar spine and femur neck remained unchanged after one year of adalimumab therapy (+0.3% and +0.3%, respectively). Of interest, a beneficial effect of prednisone on change in femur neck BMD was observed with a relative increase with prednisone use (+2.5%) compared to no concomitant prednisone use (-0.7%), (P = 0.015).
Conclusion In contrast to the progressive bone loss observed after conventional disease modifying anti rheumatic drug therapy, TNF blockade may result in an arrest of general bone loss. Consistent with previous observations, the data also suggest that the net effect of low dose corticosteroids on BMD in RA may be beneficial, possibly resulting from their anti-inflammatory effects.
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
