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Early effects of tumor necrosis factor inhibition on bone homeostasis after soluble tumor necrosis factor receptor use.

Lim MJ, Kwon SR, Joo K, Son MJ, Park SG, Park W - Korean J. Intern. Med. (2014)

Bottom Line: In patients whose DAS28 improved, the sclerostin level increased from 1.67 ± 2.12 pg/mL at baseline to 2.51 ± 3.03 pg/mL, which was statistically significant (p = 0.021).RA patients treated with DMARDs showed depressed bone metabolism compared to naive RA patients.Increases in serum CTX-1 and sclerostin levels after short-term etanercept treatment suggest reconstitution of bone metabolism homeostasis.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.

ABSTRACT

Background/aims: Our aim was to assess whether short-term treatment with soluble tumor necrosis factor (TNF) receptor affects circulating markers of bone metabolism in rheumatoid arthritis (RA) patients.

Methods: Thirty-three active RA patients, treated with oral disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids for > 6 months, were administered etanercept for 12 weeks. Serum levels of bone metabolism markers were compared among patients treated with DMARDs at baseline and after etanercept treatment, normal controls and naive RA patients not previously treated with DMARDs (both age- and gender-matched).

Results: Bone-specific alkaline phosphatase (BSALP) and serum c-telopeptide (CTX)-1 levels were lower in RA patients treated with DMARDs than in DMARD-naive RA patients. After 12 weeks of etanercept treatment, serum CTX-1 and sclerostin levels increased. In patients whose DAS28 improved, the sclerostin level increased from 1.67 ± 2.12 pg/mL at baseline to 2.51 ± 3.03 pg/mL, which was statistically significant (p = 0.021). Increases in sclerostin levels after etanercept treatment were positively correlated with those of serum CTX-1 (r = 0.775), as were those of BSALP (r = 0.755).

Conclusions: RA patients treated with DMARDs showed depressed bone metabolism compared to naive RA patients. Increases in serum CTX-1 and sclerostin levels after short-term etanercept treatment suggest reconstitution of bone metabolism homeostasis.

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Related in: MedlinePlus

(A) Serum c-telopeptide (CTX)-1, (B) sclerostin, and (C) bone-specific alkaline phosphatase (BSALP) levels among normal controls, drug-naive rheumatoid arthritis (RA) patients, and RA patients treated chronically with disease-modifying antirheumatic drugs (DMARDs) at baseline and after 12 weeks of etanercept treatment.
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Figure 1: (A) Serum c-telopeptide (CTX)-1, (B) sclerostin, and (C) bone-specific alkaline phosphatase (BSALP) levels among normal controls, drug-naive rheumatoid arthritis (RA) patients, and RA patients treated chronically with disease-modifying antirheumatic drugs (DMARDs) at baseline and after 12 weeks of etanercept treatment.

Mentions: In RA patients treated chronically with DMARDs and glucocorticoids prior to etanercept, both BSALP and CTX-1 levels were significantly lower than in RA patients not yet treated with any DMARD or glucocorticoids (p = 0.004, p = 0.024, respectively). After 12 weeks of etanercept treatment, serum BSALP, sclerostin, and CTX-1 levels increased, the latter significantly (Fig. 1). Increases in sclerostin levels after etanercept treatment correlated positively with those of serum CTX-1 (r = 0.775, p < 0.001). Examination of serum levels of bone metabolism markers revealed that changes in BSALP were correlated with those in CTX-1 (r = 0.755, p < 0.001) (Fig. 2). Levels of other bone metabolism markers including, OPG/RANKL, P1NP, DKK-1, were not affected significantly by etanercept treatment (Table 2).


Early effects of tumor necrosis factor inhibition on bone homeostasis after soluble tumor necrosis factor receptor use.

Lim MJ, Kwon SR, Joo K, Son MJ, Park SG, Park W - Korean J. Intern. Med. (2014)

(A) Serum c-telopeptide (CTX)-1, (B) sclerostin, and (C) bone-specific alkaline phosphatase (BSALP) levels among normal controls, drug-naive rheumatoid arthritis (RA) patients, and RA patients treated chronically with disease-modifying antirheumatic drugs (DMARDs) at baseline and after 12 weeks of etanercept treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219971&req=5

Figure 1: (A) Serum c-telopeptide (CTX)-1, (B) sclerostin, and (C) bone-specific alkaline phosphatase (BSALP) levels among normal controls, drug-naive rheumatoid arthritis (RA) patients, and RA patients treated chronically with disease-modifying antirheumatic drugs (DMARDs) at baseline and after 12 weeks of etanercept treatment.
Mentions: In RA patients treated chronically with DMARDs and glucocorticoids prior to etanercept, both BSALP and CTX-1 levels were significantly lower than in RA patients not yet treated with any DMARD or glucocorticoids (p = 0.004, p = 0.024, respectively). After 12 weeks of etanercept treatment, serum BSALP, sclerostin, and CTX-1 levels increased, the latter significantly (Fig. 1). Increases in sclerostin levels after etanercept treatment correlated positively with those of serum CTX-1 (r = 0.775, p < 0.001). Examination of serum levels of bone metabolism markers revealed that changes in BSALP were correlated with those in CTX-1 (r = 0.755, p < 0.001) (Fig. 2). Levels of other bone metabolism markers including, OPG/RANKL, P1NP, DKK-1, were not affected significantly by etanercept treatment (Table 2).

Bottom Line: In patients whose DAS28 improved, the sclerostin level increased from 1.67 ± 2.12 pg/mL at baseline to 2.51 ± 3.03 pg/mL, which was statistically significant (p = 0.021).RA patients treated with DMARDs showed depressed bone metabolism compared to naive RA patients.Increases in serum CTX-1 and sclerostin levels after short-term etanercept treatment suggest reconstitution of bone metabolism homeostasis.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.

ABSTRACT

Background/aims: Our aim was to assess whether short-term treatment with soluble tumor necrosis factor (TNF) receptor affects circulating markers of bone metabolism in rheumatoid arthritis (RA) patients.

Methods: Thirty-three active RA patients, treated with oral disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids for > 6 months, were administered etanercept for 12 weeks. Serum levels of bone metabolism markers were compared among patients treated with DMARDs at baseline and after etanercept treatment, normal controls and naive RA patients not previously treated with DMARDs (both age- and gender-matched).

Results: Bone-specific alkaline phosphatase (BSALP) and serum c-telopeptide (CTX)-1 levels were lower in RA patients treated with DMARDs than in DMARD-naive RA patients. After 12 weeks of etanercept treatment, serum CTX-1 and sclerostin levels increased. In patients whose DAS28 improved, the sclerostin level increased from 1.67 ± 2.12 pg/mL at baseline to 2.51 ± 3.03 pg/mL, which was statistically significant (p = 0.021). Increases in sclerostin levels after etanercept treatment were positively correlated with those of serum CTX-1 (r = 0.775), as were those of BSALP (r = 0.755).

Conclusions: RA patients treated with DMARDs showed depressed bone metabolism compared to naive RA patients. Increases in serum CTX-1 and sclerostin levels after short-term etanercept treatment suggest reconstitution of bone metabolism homeostasis.

Show MeSH
Related in: MedlinePlus