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Basic and translational research
Concise report
Sclerostin inhibition reverses systemic, periarticular and local bone loss in arthritis
  1. Xiao-Xiang Chen1,2,
  2. Wolfgang Baum1,
  3. Denise Dwyer3,
  4. Michael Stock1,
  5. Kay Schwabe1,
  6. Hua-Zhu Ke3,
  7. Marina Stolina3,
  8. Georg Schett1,
  9. Aline Bozec1,4
  1. 1Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
  2. 2Department of Rheumatology, Renji Hospital, Shanghai, China
  3. 3Amgen Inc., Thousand Oaks, California, USA
  4. 4Nikolaus Fiebiger Center of Molecular Medicine, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany
  1. Correspondence to Professor Aline Bozec or Georg Schett, Department of Internal Medicine 3 and Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen 91054, Germany; aline.bozec{at}uk-erlangen.de or georg.schett{at}uk-erlangen.de

Abstract

Objective To test whether inhibition of sclerostin by a targeted monoclonal antibody (Scl-Ab) protects from bone and cartilage damage in inflammatory arthritis. Sclerostin is a potent inhibitor of bone formation and may be responsible for the low level of bone repair in patients with rheumatoid arthritis.

Methods Human tumour necrosis factor transgenic mice (hTNFtg mice) developing inflammatory arthritis and local and bone loss were administered either vehicle, anti-TNF antibody, Scl-Ab, or a combination of both agents. Inflammation, systemic and periarticular bone loss, bone erosion and cartilage damage were evaluated at baseline (week 8) and after 3 weeks of treatment by clinical assessment, micro-CT and histology.

Results Scl-Ab did not affect joint swelling or synovitis. Systemic bone loss in the spine and periarticular bone loss in the proximal tibia were completely blocked and partially reversed by inhibition of sclerostin but not by inhibition of TNF. Moreover, Scl-Ab completely arrested the progression of bone erosion in hTNFtg mice and in combination with TNF inhibition even led to significant regression of cortical bone erosions. Protective effects of Scl-Ab were also observed for the articular cartilage.

Conclusions These data suggest that sclerostin inhibition is a powerful tool to enhance bone repair in inflammatory arthritis.

  • Anti-TNF
  • Rheumatoid Arthritis
  • Inflammation
  • Bone Mineral Density

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/annrheumdis-2013-203345

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