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AB0313 Short-Term Effects of Tnf Inhibitors on Bone Turnover Markers and Bone Mineral Density in Rheumatoid Arthritis
  1. G. Orsolini,
  2. G. Adami,
  3. O. Viapiana,
  4. L. Idolazzi,
  5. A. Fassio,
  6. M. Vitiello,
  7. D. Gatti,
  8. M. Rossini
  1. Rheumatology Section, Department Medicine, University of Verona, Verona, Italy


Background 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.

Objectives Here we investigated the short-term effects of TNFαI therapy on bone metabolism and density.

Methods We studied 54 patients with RA starting a TNFI 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 (BTM): N-propeptide of type I collagen (P1NP), and bone alkaline phosphates (bAP) 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 (DEXA).

Results All bone markers rose significantly and these changes were not dependent on steroids dosage; a significant decrease in femoral neck BMD was also observed (see Table).

Conclusions 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.

Disclosure of Interest None declared

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