PT  - JOURNAL ARTICLE
AU  - Wijbrandts, C A
AU  - Klaasen, R
AU  - Dijkgraaf, M G W
AU  - Gerlag, D M
AU  - van Eck-Smit, B L F
AU  - Tak, P P
TI  - Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss
AID  - 10.1136/ard.2008.091611
DP  - 2009 Mar 01
TA  - Annals of the Rheumatic Diseases
PG  - 373--376
VI  - 68
IP  - 3
4099  - http://ard.bmj.com/content/68/3/373.short
4100  - http://ard.bmj.com/content/68/3/373.full
SO  - Ann Rheum Dis2009 Mar 01; 68
AB  - Objective: To explore the effects of anti-tumour necrosis factor (TNF)α antibody therapy on bone mineral density (BMD) of the lumbar spine and femur neck in patients with rheumatoid arthritis (RA).Methods: A total of 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 (⩽10 mg/day). The BMD of the lumbar spine and femur neck was measured before and 1 year after start of treatment.Results: Disease activity at baseline (28-joint Disease Activity Score (DAS28)) and disease duration were inversely correlated with femoral neck BMD and lumbar spine BMD (p<0.05). Mean BMD of lumbar spine and femur neck remained unchanged after 1 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 antirheumatic 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.