Treatment With Infliximab Is Associated With Increased Markers of Bone Formation in Patients With Crohn's Disease

Abstract

Treatment with infliximab was associated with increased markers of bone formation (BAP) without increasing bone resorption (NTX). This effect may be due to a beneficial effect of TNF-alpha blockade on bone turnover, a beneficial effect on CD activity resulting in decreased glucocorticoid dose, or both. Studies of longer duration are needed to assess the effect of infliximab on bone mineral density.

Adalimumab Therapy Has a Beneficial Effect on Bone Metabolism in Patients with Crohn’s Disease

“…There was a significant and rapid increase in OC and P1NP, markers of bone formation, and a decrease, albeit non-significant, in sCTx, a marker of bone resorption. Our results are comparable to those found in studies looking at the effect of infliximab on bone metabolism in CD patients [17,18]. These favourable effects were not associated with baseline CDAI's, DEXA findings, disease location, concomitant medical therapy, previous TNF-α exposure, current steroid therapy or indeed on biological response to Adalimumab.…”

“…These effects seem to be independent of whether the patients are classified as responders or non-responders to infliximab treatment based on clinical scores, and of whether the patients are on steroid therapy [16][17][18]. Patients who received infliximab have also been shown to have increased BMD based on DXA findings [21][22][23].…”

“…To date, data describing the effects of in vivo TNF-α inhibition on general bone metabolism in patients with IBD are still limited and restricted to infliximab treatment [16][17][18][19][20].…”

“…The beneficial effects appear to be primarily due to an increase in bone formation, while reduction in bone resorption seems to play a lesser role [17,18].…”

Sarcopenia is prevalent in patients with Crohnʼs disease in clinical remission

“…26 Being able to quantify sarcopenia in a reliable, affordable, and readily available way will help improve clinical management of CD patients and further our understanding of the mechanisms behind sarcopenia. Infliximab has been shown to improve osteopenia in CD patients, 38,48 and should therefore be evaluated in CD-associated sarcopenia. Physical activity and exercise should be advocated once remission is achieved.…”