RESEARCH - More bone formation, less resporption with Remicade for RA

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More Bone Formation, Less Resorption With Infliximab for RA

NEW YORK (Reuters Health) Apr 11 - There is an improvement in the

formation of bone and a reduction in bone resorption markers with the

use of the anti-tumor necrosis factor-alpha (anti-TNF-alpha) drug

infliximab in patients with rheumatoid arthritis (RA) whose disease

has not responded to standard therapy.

The formation/resorption ratio " suggests beneficial systemic and local

bone effects of infliximab in patients with RA, " French investigators

report in the March issue of the ls of the Rheumatic Diseases.

RA is associated with systemic bone loss, subchondral bone erosion and

cartilage degradation caused by pro-inflammatory cytokines, including

tumour necrosis factor-alpha (TNF-alpha).

Dr. Thierry of the University Hospital of Saint-Etienne and

colleagues administered the anti-TNF-alpha monoclonal antibody to 48

women who had severe RA for a mean of 11.4 years. Infliximab was

started after failure of other disease-modifying antirheumatic drugs

and investigators measured biochemical markers of bone turnover at

baseline and after 6, 22 and 54 weeks.

Bone mineral density (BMD) remained stable over 1 year. Serum

cathepsin K levels, a marker of cartilage degradation, rapidly

decreased by 19% at week 6 and 28% at week 22. However, by week 54,

the marker returned to pre-treatment levels.

In contrast, the marker for matrix metalloprotease levels

progressively declined to a maximum of 25% decrease at week 54.

" In summary, the improvement in the formation/resorption marker ratio

suggests beneficial systemic and local bone effects of infliximab in

patients with RA, " Dr. and colleagues note.

Studies are planned to determine if the biochemical changes translate

to true positive structural effects on bone with infliximab therapy.

Ann Rheum Dis 2008;67:353-357.

http://www.medscape.com/viewarticle/572879

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Not an MD