Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NFκB ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis.
Open accessAbstract
Objectives To examine whether treatment with anti-tumour necrosis factor (TNF) alpha prevents loss of bone mineral density (BMD) at the spine and hip (generalised) and in the hands (local) of patients with rheumatoid arthritis, and to study the changes in markers of bone metabolism, including receptor activator of the NFkappaB ligand (RANKL) and osteoprotegerin (OPG), during anti-TNF treatment.Patients and methods 102 patients with active rheumatoid arthritis, who were treated with infliximab during 1 year, were included in this open cohort study. The BMD of the spine and hip (dual x ray absorptiometry) and hands dual x ray radiogrammetry was measured before the start of treatment and after 1 year. Changes in osteocalcin formation, beta-isomerised carboxy terminal telopeptide of type 1 collagen (beta-CTx, resorption), RANKL and OPG were determined at 0, 14, 30 and 46 weeks.Results The BMD of the spine and hip was unchanged during treatment with infliximab, whereas BMD of the hand decreased significantly by 0.8% (p<0.01). The BMD of the hip in patients with a good European League Against Rheumatism response showed a favourable change compared with patients not achieving such a response. Serum beta-CTx and RANKL were both considerably decreased compared with baseline at all time points. The decrease in beta-CTx was associated with the decrease in Disease Activity Score of 28 joints and C reactive protein during the 0-14 weeks interval.Conclusion In patients with rheumatoid arthritis treated with infliximab, spine and hip bone loss is arrested, whereas metacarpal cortical hand bone loss is not stopped. The outcome of the study also supports a relationship between clinical response, in terms of reduced inflammatory activity, and changes in bone loss of the spine, hip and hands.
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Infliximab treatment in RA causes a decline in serum RANKL and the OPG/RANKL ratio but no change in serum OPG.
“Vis et al. (428) found that infliximab treatment in RA caused a decline in serum RANKL and the OPG/RANKL ratio but no change in serum OPG.”
From Receptor Activator of Nuclear Factor κB Ligand and Osteoprotegerin Regulation of Bone Remodeling in Health and Disease (2008) · cites this paper as [428]
Infliximab treatment is associated with stabilization of BMD at the hip and spine but continued bone loss in the hand.
“Infliximab treatment was also associated with stabilization of BMD at the hip and spine but continued bone loss in the hand (428).”
From Receptor Activator of Nuclear Factor κB Ligand and Osteoprotegerin Regulation of Bone Remodeling in Health and Disease (2008) · cites this paper as [428]
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- Authors
- Vis, M., Havaardsholm, E. A., Haugeberg, G., Uhlig, T., Voskuyl, A. E., van de Stadt, R. J., Dijkmans, B. A. C., Woolf, A. D., Kvien, T. K., & Lems, W. F.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Diakonhjemmet Hospital (NO)
- Slotervaartziekenhuis (NL)
- Royal Cornwall Hospital (GB)
- Corresponding author
- Vis, M
- Venue
- Annals of the Rheumatic Diseases
- Publisher
- Elsevier BV
- Published
- 2006-11
- Volume
- 65
- Issue
- 11
- Pages
- 1495-1499
- ISSN
- 0003-4967 (ISSN-L)
- PMC
- PMC1798341
- OpenAlex
- W2037787276
- Cited by
- 246
- References
- 30
- Citations by year
- 2026: 9 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 12 · 2021: 20 · 2020: 8 · 2019: 11 · 2018: 12 · 2017: 11 · 2016: 13 · 2015: 19 · 2014: 17 · 2013: 12 · 2012: 17
- FWCI
- 9.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of the Rheumatic Diseases (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- rheumatoid arthritis, infliximab, bone mineral density, bone loss, anti-TNF therapy, RANKL, osteoprotegerin, bone turnover markers, osteocalcin, β-CTX, disease activity, C-reactive protein
- MeSH terms
- Infliximab, Adult, Aged, Antibodies, Monoclonal, Arthritis, Rheumatoid, Bone and Bones, Carrier Proteins, Female, Glycoproteins, Hip Joint, Humans, Ligands, Male, Membrane Glycoproteins, Middle Aged, Osteoporosis, Severity of Illness Index, Spine, Tumor Necrosis Factor-alpha, Biomarkers, Bone Density, Receptors, Tumor Necrosis Factor, Receptors, Cytoplasmic and Nuclear, Antirheumatic Agents, Hand Bones, Osteoprotegerin, RANK Ligand, Receptor Activator of Nuclear Factor-kappa B
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