Body weight, body composition, and bone turnover changes in patients with spondyloarthropathy receiving anti-tumour necrosis factor   treatment

Abstract

Objectives: To determine the changes in body weight, body composition, and bone turnover in patients with spondyloarthropathy (SpA) treated with anti-tumour necrosis factor a (TNFa). Patients and methods: 19 patients with SpA (2 women, 17 men), aged 21-71 years, were studied in a 1 year prospective open study. 17 patients received infliximab: 3 or 5 mg/kg/infusion at weeks 0, 2, 6 and infusions in the case of a relapse (n = 14) or systematically (n = 3); 2 patients received etanercept (25 mg twice a week). Body weight, body composition (lean mass, fat mass), and bone mineral density (BMD; using dual energy x ray absorptiometry) were measured at baseline and at months 6 and 12. Serum insulin-like growth factor-I (IGF-I), bone markers (carboxy terminal telopeptide of collagen I (CTX) and procollagen type I N terminal propeptide (PINP)) were measured at baseline and months 3, 6, and 12.Results: In 1 year there was a significant increase in body weight (mean (SD) 2.24 (3.1) kg, p = 0.0004), and in lean mass (1.4 (1.69) kg, p = 0.005), but no changes in fat mass. BMD increased at the spine (5.6%, p = 0.0005) and total femur (2.6%, p = 0.01). CTX decreased from the third month (250%, p = 0.005) up to 1 year (230%, p = 0.012), and a trend for an increase in PINP (10%, p = 0.06) and in IGF-I (15%, p = 0.04) was seen at month 3. Conclusion: These data confirm that treatment with anti-TNFa in SpA is associated with an increase of BMD, which results from a decrease of bone resorption. Increase in body weight and lean mass is observed in parallel with an increase in IGF-1.

Relationship of bone mineral density with disease activity and functional ability in patients with ankylosing spondylitis: a cross-sectional study

“…Inflammation may influence bone metabolism due to the effect of pro-inflammatory mediators such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha, which play an important role in bone loss through their effect on osteoclast activity [14]. The most suggestive findings that inflammation contributes to bone loss in the spine come indirectly from studies confirming that in patients receiving anti TNF therapy there is not only a significant improvement of symptoms and a decrease of inflammation, but also an increase in BMD [15][16][17][18].…”

Biochemical markers of psoriasis as a metabolic disease

“…Therefore, elevated levels of TNF-alpha, which are observed in the serum of patients with psoriasis, may also result from the severe inflammatory process in psoriasis as well as from the contribution of other cells in the synthesis of this cytokine [63]. It is interesting that several research studies have shown increased body weight in patients with psoriasis after therapy with anti-TNF--alpha agents [140][141][142].…”

Mechanism-Based Therapeutic Approaches to Cachexia

“…As an example, etanercept (chimeric soluble TNF receptor 2) or infliximab (anti-TNF monoclonal antibody) were reported to increase body weight and lean body mass in patients with rheumatoid arthritis (Briot et al, 2005). Such observation however, was not confirmed by a different study (Marcora et al, 2006).…”