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Body weight, body composition, and bone turnover changes in patients with spondyloarthropathy receiving anti-tumour necrosis factor α treatment
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  1. K Briot1,
  2. P Garnero2,
  3. A Le Henanff1,
  4. M Dougados1,
  5. C Roux1
  1. 1Rheumatology Department, Cochin Hospital, René Descartes University, Paris, France
  2. 2INSERM Research Unit 403 and Molecular Markers, SYNARC Lyon, France
  1. Correspondence to:
    Professor C Roux
    Hôpital Cochin, Département de Rhumatologie, 27 rue du Faubourg St Jacques, 75014 Paris, France; christian.rouxcch.ap-hop-paris.fr

Abstract

Objectives: To determine the changes in body weight, body composition, and bone turnover in patients with spondyloarthropathy (SpA) treated with anti-tumour necrosis factor α (TNFα).

Patients and methods: 19 patients with SpA (2 women, 17 men), aged 21–71 years, were studied in a 1 year prospective open study. 17 patients received infliximab: 3 or 5 mg/kg/infusion at weeks 0, 2, 6 and infusions in the case of a relapse (n = 14) or systematically (n = 3); 2 patients received etanercept (25 mg twice a week). Body weight, body composition (lean mass, fat mass), and bone mineral density (BMD; using dual energy x ray absorptiometry) were measured at baseline and at months 6 and 12. Serum insulin-like growth factor-I (IGF-I), bone markers (carboxy terminal telopeptide of collagen Ι (CTX) and procollagen type Ι N terminal propeptide (PINP)) were measured at baseline and months 3, 6, and 12.

Results: In 1 year there was a significant increase in body weight (mean (SD) 2.24 (3.1) kg, p = 0.0004), and in lean mass (1.4 (1.69) kg, p = 0.005), but no changes in fat mass. BMD increased at the spine (5.6%, p = 0.0005) and total femur (2.6%, p = 0.01). CTX decreased from the third month (−50%, p = 0.005) up to 1 year (−30%, p = 0.012), and a trend for an increase in PINP (10%, p = 0.06) and in IGF-I (15%, p = 0.04) was seen at month 3.

Conclusion: These data confirm that treatment with anti-TNFα in SpA is associated with an increase of BMD, which results from a decrease of bone resorption. Increase in body weight and lean mass is observed in parallel with an increase in IGF-1.

  • BASDAI, Bath Ankylosing Spondylitis Disease Activity Index
  • BASFI, Bath Ankylosing Spondylitis Functional Index
  • BMD, bone mineral density
  • CRP, C reactive protein
  • CTX, carboxy terminal telopeptide of type I collagen
  • DXA, dual energy x ray absorptiometry
  • ESR, erythrocyte sedimentation rate
  • GH, growth hormone
  • IGF-I, insulin-like growth factor-I
  • IL, interleukin
  • PINP, procollagen type I N-terminal propeptide
  • RA, rheumatoid arthritis
  • SpA, spondyloarthropathy
  • TNFα, tumour necrosis factor α
  • anti-tumour necrosis factor
  • spondyloarthropathy
  • osteoporosis
  • body composition
  • bone remodelling

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