• Users Online: 91
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2017  |  Volume : 12  |  Issue : 1  |  Page : 31-37

Effect of anti-tumor necrosis factor alpha therapy on bone health and biomarkers of bone turnover in Indian patients with ankylosing spondylitis


1 Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Medicine, AIIMS, New Delhi, India

Correspondence Address:
Shefali Khanna Sharma
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, 458, Sector 37-A, Chandigarh - 160. 036
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-3698.199131

Rights and Permissions

Background: We evaluated the relationship between bone mineral density (BMD) and biomarkers of bone turnover in ankylosing spondylitis (AS) patients treated with anti-tumor necrosis factor alpha (TNF-α) agents. Methods: Fifty-one AS patients were screened, of which 27 were started on anti-TNF therapy in accordance to the assessment of AS guidelines. Detailed assessments of erythrocyte sedimentation ratio (ESR), Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), Bath AS metrological index (BASMI), AS disease activity score-ESR, and AS quality of life (AsQOL) questionnaire were done at baseline and 6 months. Vitamin D, parathyroid hormone, and osteocalcin were measured along with BMD of the lumbar spine, anteroposterior (AP) and lateral view, and hip. Results: Out of 27 patients, 12 patients had osteoporosis. At 6 months, significant improvements were seen for BASDAI (mean 2.33 ± 1.08, P < 0.01), BASFI (3 ± 1.31, P < 0.01), BASMI (3 ± 3.05,P = 0.019), and AsQOL (4 ± 3.02, P < 0.01) and these correlated with a decrease in ESR (15.6 ± 10.8,P = 0.01) at 6 months. The mean increase in BMD at the neck of femur, total hip, and lumbar AP view was 3.2% (P = 0.007), 3.1% (P = 0.004), and 2.5% (P < 0.001), respectively. The serum alkaline phosphatase level increased from a mean value of 190.3 ± 70.8 IU/ml at baseline to 225.4 ± 59.8 IU/ml, which was statistically significant at the 6-month follow-up (P = 0.006). The serum osteocalcin levels showed an increasing trend from a mean value of 2.32 ± 1.6 ng/ml at baseline to 3.32 ± 3.02 ng/ml at 6 months. Conclusion: Anti-TNF-α has a beneficial effect on bone metabolism resulting in improved bone formation.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed492    
    Printed6    
    Emailed0    
    PDF Downloaded45    
    Comments [Add]    

Recommend this journal