Effects of 1-year anti-TNF-α therapies on bone mineral density and bone biomarkers in rheumatoid arthritis and ankylosing spondylitis

Katalin Gulyás, Ágnes Horváth, Edit Végh, Anita Pusztai, Ágnes Szentpétery, Zsófia Pethö, Andrea Váncsa, Nóra Bodnár, Péter Csomor, Attila Hamar, Levente Bodoki, Harjit Pal Bhattoa, Balázs Juhász, Zoltán Nagy, Katalin Hodosi, Tamás Karosi, Oliver FitzGerald, Gabriella Szücs, Zoltán Szekanecz, Szilvia SzamosiSándor Szántó

Research output: Article

Abstract

Objectives: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with generalized and localized bone loss. We conducted a comprehensive study using imaging (dual-energy X-ray absorptiometry, DXA) and laboratory biomarkers in order to determine bone health and to study the effects of anti-tumor necrosis factor (TNF) biologics in RA and AS. Patients and methods: Thirty-six RA and 17 AS patients undergoing 1-year etanercept (ETN) or certolizumab-pegol (CZP) therapy were studied. Bone density was assessed by DXA at baseline and after 12 months. Serum C-reactive protein (CRP), calcium, phosphate, parathyroid hormone (PTH), vitamin D3, osteocalcin, procollagen type I N-propeptide (P1NP), C-terminal telopeptide (βCTX), osteoprotegerin, sclerostin (SOST), Dickkopf-1 (DKK-1), soluble receptor activator nuclear kappa B ligand (sRANKL), and cathepsin K (cathK) levels were determined at baseline and after 6 and 12 months. Results: TNF-α inhibition was clinically effective. Anti-TNF-α halted further bone loss over 1 year. In general, anti-TNF therapy significantly increased P1NP, SOST levels, and the P1NP/βCTX ratios, while decreased DKK-1 and CathK production at different time points in most patient subsets. In the full cohort and in RA, baseline and/or 12-month bone mineral density (BMD) at multiple sites exerted inverse relationships with CRP and βCTX, and positive correlation with SOST. In AS, L2-4 BMD after 1-year biologic therapy inversely correlated with baseline βCTX, while femoral neck BMD rather showed inverse correlations with CRP. Conclusions: Anti-TNF therapy slowed down generalized bone loss, in association with clinical improvements, in both diseases. TNF blockade may enhance bone formation and suppress joint destruction. Anti-TNF therapy may act inversely on DKK-1 and SOST. Independent predictors of BMD were SOST and βCTX in RA, whilst CRP in AS.Key Points• One-year anti-TNF therapy halted generalized bone loss in association with clinical improvement in arthritides.• Anti-TNF therapy may inversely act on DKK-1 and SOST.• Independent predictors of BMD were SOST and βCTX in RA, while CRP in AS.

Original languageEnglish
JournalClinical rheumatology
DOIs
Publication statusAccepted/In press - jan. 1 2019

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Ankylosing Spondylitis
Bone Density
Rheumatoid Arthritis
Tumor Necrosis Factor-alpha
Biomarkers
Bone and Bones
C-Reactive Protein
Therapeutics
Photon Absorptiometry
Cathepsin K
Osteoprotegerin
Biological Therapy
Cholecalciferol
Femur Neck
Osteocalcin
Cytoplasmic and Nuclear Receptors
Collagen Type I
Biological Products
Parathyroid Hormone
Osteogenesis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Effects of 1-year anti-TNF-α therapies on bone mineral density and bone biomarkers in rheumatoid arthritis and ankylosing spondylitis. / Gulyás, Katalin; Horváth, Ágnes; Végh, Edit; Pusztai, Anita; Szentpétery, Ágnes; Pethö, Zsófia; Váncsa, Andrea; Bodnár, Nóra; Csomor, Péter; Hamar, Attila; Bodoki, Levente; Bhattoa, Harjit Pal; Juhász, Balázs; Nagy, Zoltán; Hodosi, Katalin; Karosi, Tamás; FitzGerald, Oliver; Szücs, Gabriella; Szekanecz, Zoltán; Szamosi, Szilvia; Szántó, Sándor.

In: Clinical rheumatology, 01.01.2019.

Research output: Article

Gulyás, K, Horváth, Á, Végh, E, Pusztai, A, Szentpétery, Á, Pethö, Z, Váncsa, A, Bodnár, N, Csomor, P, Hamar, A, Bodoki, L, Bhattoa, HP, Juhász, B, Nagy, Z, Hodosi, K, Karosi, T, FitzGerald, O, Szücs, G, Szekanecz, Z, Szamosi, S & Szántó, S 2019, 'Effects of 1-year anti-TNF-α therapies on bone mineral density and bone biomarkers in rheumatoid arthritis and ankylosing spondylitis', Clinical rheumatology. https://doi.org/10.1007/s10067-019-04771-3
Gulyás, Katalin ; Horváth, Ágnes ; Végh, Edit ; Pusztai, Anita ; Szentpétery, Ágnes ; Pethö, Zsófia ; Váncsa, Andrea ; Bodnár, Nóra ; Csomor, Péter ; Hamar, Attila ; Bodoki, Levente ; Bhattoa, Harjit Pal ; Juhász, Balázs ; Nagy, Zoltán ; Hodosi, Katalin ; Karosi, Tamás ; FitzGerald, Oliver ; Szücs, Gabriella ; Szekanecz, Zoltán ; Szamosi, Szilvia ; Szántó, Sándor. / Effects of 1-year anti-TNF-α therapies on bone mineral density and bone biomarkers in rheumatoid arthritis and ankylosing spondylitis. In: Clinical rheumatology. 2019.
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TY - JOUR

T1 - Effects of 1-year anti-TNF-α therapies on bone mineral density and bone biomarkers in rheumatoid arthritis and ankylosing spondylitis

AU - Gulyás, Katalin

AU - Horváth, Ágnes

AU - Végh, Edit

AU - Pusztai, Anita

AU - Szentpétery, Ágnes

AU - Pethö, Zsófia

AU - Váncsa, Andrea

AU - Bodnár, Nóra

AU - Csomor, Péter

AU - Hamar, Attila

AU - Bodoki, Levente

AU - Bhattoa, Harjit Pal

AU - Juhász, Balázs

AU - Nagy, Zoltán

AU - Hodosi, Katalin

AU - Karosi, Tamás

AU - FitzGerald, Oliver

AU - Szücs, Gabriella

AU - Szekanecz, Zoltán

AU - Szamosi, Szilvia

AU - Szántó, Sándor

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with generalized and localized bone loss. We conducted a comprehensive study using imaging (dual-energy X-ray absorptiometry, DXA) and laboratory biomarkers in order to determine bone health and to study the effects of anti-tumor necrosis factor (TNF) biologics in RA and AS. Patients and methods: Thirty-six RA and 17 AS patients undergoing 1-year etanercept (ETN) or certolizumab-pegol (CZP) therapy were studied. Bone density was assessed by DXA at baseline and after 12 months. Serum C-reactive protein (CRP), calcium, phosphate, parathyroid hormone (PTH), vitamin D3, osteocalcin, procollagen type I N-propeptide (P1NP), C-terminal telopeptide (βCTX), osteoprotegerin, sclerostin (SOST), Dickkopf-1 (DKK-1), soluble receptor activator nuclear kappa B ligand (sRANKL), and cathepsin K (cathK) levels were determined at baseline and after 6 and 12 months. Results: TNF-α inhibition was clinically effective. Anti-TNF-α halted further bone loss over 1 year. In general, anti-TNF therapy significantly increased P1NP, SOST levels, and the P1NP/βCTX ratios, while decreased DKK-1 and CathK production at different time points in most patient subsets. In the full cohort and in RA, baseline and/or 12-month bone mineral density (BMD) at multiple sites exerted inverse relationships with CRP and βCTX, and positive correlation with SOST. In AS, L2-4 BMD after 1-year biologic therapy inversely correlated with baseline βCTX, while femoral neck BMD rather showed inverse correlations with CRP. Conclusions: Anti-TNF therapy slowed down generalized bone loss, in association with clinical improvements, in both diseases. TNF blockade may enhance bone formation and suppress joint destruction. Anti-TNF therapy may act inversely on DKK-1 and SOST. Independent predictors of BMD were SOST and βCTX in RA, whilst CRP in AS.Key Points• One-year anti-TNF therapy halted generalized bone loss in association with clinical improvement in arthritides.• Anti-TNF therapy may inversely act on DKK-1 and SOST.• Independent predictors of BMD were SOST and βCTX in RA, while CRP in AS.

AB - Objectives: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with generalized and localized bone loss. We conducted a comprehensive study using imaging (dual-energy X-ray absorptiometry, DXA) and laboratory biomarkers in order to determine bone health and to study the effects of anti-tumor necrosis factor (TNF) biologics in RA and AS. Patients and methods: Thirty-six RA and 17 AS patients undergoing 1-year etanercept (ETN) or certolizumab-pegol (CZP) therapy were studied. Bone density was assessed by DXA at baseline and after 12 months. Serum C-reactive protein (CRP), calcium, phosphate, parathyroid hormone (PTH), vitamin D3, osteocalcin, procollagen type I N-propeptide (P1NP), C-terminal telopeptide (βCTX), osteoprotegerin, sclerostin (SOST), Dickkopf-1 (DKK-1), soluble receptor activator nuclear kappa B ligand (sRANKL), and cathepsin K (cathK) levels were determined at baseline and after 6 and 12 months. Results: TNF-α inhibition was clinically effective. Anti-TNF-α halted further bone loss over 1 year. In general, anti-TNF therapy significantly increased P1NP, SOST levels, and the P1NP/βCTX ratios, while decreased DKK-1 and CathK production at different time points in most patient subsets. In the full cohort and in RA, baseline and/or 12-month bone mineral density (BMD) at multiple sites exerted inverse relationships with CRP and βCTX, and positive correlation with SOST. In AS, L2-4 BMD after 1-year biologic therapy inversely correlated with baseline βCTX, while femoral neck BMD rather showed inverse correlations with CRP. Conclusions: Anti-TNF therapy slowed down generalized bone loss, in association with clinical improvements, in both diseases. TNF blockade may enhance bone formation and suppress joint destruction. Anti-TNF therapy may act inversely on DKK-1 and SOST. Independent predictors of BMD were SOST and βCTX in RA, whilst CRP in AS.Key Points• One-year anti-TNF therapy halted generalized bone loss in association with clinical improvement in arthritides.• Anti-TNF therapy may inversely act on DKK-1 and SOST.• Independent predictors of BMD were SOST and βCTX in RA, while CRP in AS.

KW - Biologics

KW - Bone loss

KW - DKK-1

KW - Erosion

KW - JAK inhibitors

KW - Osteoporosis

KW - Osteoprotegerin

KW - RANKL

KW - Rheumatoid arthritis

KW - Sclerostin

KW - Spondyloarthritis

KW - Syndesmophyte

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U2 - 10.1007/s10067-019-04771-3

DO - 10.1007/s10067-019-04771-3

M3 - Article

C2 - 31522318

AN - SCOPUS:85073990154

JO - Clinical Rheumatology

JF - Clinical Rheumatology

SN - 0770-3198

ER -