Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss

Abstract

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.

Glucocorticoid-Induced Osteoporosis

“…In contrast, prospective open studies show that complete control of inflammation (in parallel with clinical improvement and thus increased mobility) is accompanied by the absence of bone loss. 56 This is expected in SpA in the absence of GCs, but is also observed in RA of the hand, spine and hip, in patients receiving low doses of GCs. [56][57][58] In the BeSt study, conducted in patients with recent-onset active RA, bone loss was limited in all treated groups, including in the group initially treated with high-dose prednisone.…”

EFFICACY AND SAFETY OF ANTI-TNFα HUMAN MONOCLONAL ANTIBODIES IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS AND SECONDARY RESISTANCE TO OTHER GENETICALLY ENGINEERED BIOLOGICAL AGENTS

“…Результаты контролируемых клинических и открытых исследований позволяют заключить, что подкожное вве-дение адалимумаба эффективно и безопасно как при РА, анкилозирующем спондилите и псориатическом артрите у взрослых пациентов [10][11][12][13][14][15][16][17][18][19][20][21][22], так и при ЮИА у детей [23][24][25][26][27][28][29][30][31][32][33][34][35]. Соответственно, в случае первичной или вторич-ной неэффективности других генно-инженерных биологи-ческих препаратов переключение на адалимумаб может оказаться перспективным.…”

Biologic Therapy in Patients with Juvenile Idiopathic Arthritis – A Unique Single Centre Experience at the Scientific-Research Pediatric Centre in the Russian Federation

“…The results of controlled clinical trials and open studies demonstrated that subcutaneous administration every two weeks of the drug is safe and effective in adult patients with rheumatoid and psoriatic arthritis [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48], as well as in children with juvenile idiopathic arthritis and uveitis [49][50][51][52][53][54][55][56][57][58][59].…”