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THE INFLUENCE OF INFLIXIMAB THERAPY ON BONE MINERAL DENSITY IN PATIENTS WITH ANKYLOSING SPONDYLITIS

https://doi.org/10.14341/osteo2013313-16

Abstract

Introduction. There is evidence that patients with ankylosing spondylitis (AS) in the early stages of the disease have a significantly decreased bone mass. However, the prevalence of osteoporosis, and the mechanism of its development in the AS are poorly understood. The appearance of inhibitors of tumor necrosis factor alpha (TNF-α) significantly improved the prognosis and quality of life of patients with AS. The largest clinical experience has been gained in relation to infliximab (INF). Purpose. To assess the impact of IFN therapy on BMD of the femoral neck in patients with AS. Materials and Methods. We observed 65 male patients with a diagnosis of AS (according to the modified New York criteria 1984). In a deployed or late stage of the disease, with a high degree of activity — BASDAI > 4.0. All patients were divided into 2 groups: group 1 (n=25) — patients receiving combination therapy NSAIDs and IFN, group 2 (n=40) — patients with monotherapy at standard doses of NSAIDs (diclofenac 150 mg/ day, 200 mg of nimesulide/day meloxicam, 15 mg/day). IFN was administered a dose of 5 mg/kg of patient body weight: 1st day after 2 weeks and 6 weeks after the first injection, and after every 8 weeks. Follow-up for BMD was performed at 0 and 24 months. Results. We saw the BMD reduction at femoral neck in all patients with AS. During therapy with IFN BMD parameters showed a trend toward stabilization, which is probably due to a decrease in activity of the disease.

References

1. Дыдыкина И.С., Алексеева Л.И. Остеопороз при ревматоидном артрите: диагностика, факторы риска, переломы, лечение. Науч-практич ревматол 2011;5:13—17.

2. Geusens P, Vosse D, van der Linden S. Osteoporosis and vertebral fractures in ankylosing spondylitis. Curr Opin Rheumatol 2007;19:335—9.

3. Braun J., Sieper J. Ankylosing spondylitis. Lancet 2007;369(9570):1379—90.

4. Bessаnt R, Keat A (2002). How should clinicians mаnаge osteoporosis in аnkylosing spondylitis? J Rheumаtol 29, 1511—9.

5. Насонов Е.Л., Скрипникова И.А., Насонова В.А. Проблема остеопороза в ревматологии. Москва. Стин. 1997.

6. Kim, H.-R. Elevаted serum levels of soluble receptor аctivtor of nucker fаctor-kB legand (sRANKL) аnd reduced bone mineral density in patients with аnkylosing spondylitis/ H.-R. Kim, H.-Y. Kim, S.-H. Lee// J. Rheumаtology. — 2006. —45(10). — P. 1197—1200.

7. Capaci K., Hepguler S., Argin M., Tаs I. / Bone mineral density in mild аnd аdvаnced with аnkylosing spondylitis// Yonsei Med. J. — 2003. — 30.-44(3). — P. 379—384.

8. Румянцева О.А., Бочкова А.Г., Кузикянц К.Х., Эрдес Ш.Ф., Насонов Е. Л. Опыт длительной терапии инфликсимабом у больных анкилозирующим спондилитом. Науч-практич ревматол 2010;6:16—22.

9. Dougados М., Paternotte S., Braun J. et al. ASAS recommendations for collecting, analysing and reporting NSAID intake in clinical trials/epidemiological studies in axial spondyloarthritis. Ann Rheum Dis 2011;70:249—51.

10. Wаnders A., vаn der Heijde D., Lаndewe R., Behier J-M, Саlin A., Olivieri I., Zeidler H., Dougados М./ Nonsteroidаl аnti-inflmmtory drugs reduce radiogrphic progression in patients with аnkylosing spondylitis randomized clinicаl triäl. Arthritis Rheum 2005;52:1756—1765.

11. Heiberg M.S., Nordvag B.-Y., Mikkelsen K. et al. The comparative effectiveness of tumor necrosis factor-blocking agents in patients with rheumatoid arthritis and patients with ankylosing spondylitis. Arthr Rheum 2005;52(8):2506—12.

12. Braun J., Brandt J., Listing A., Zink A., Alten R., Burmester G., Gromnica Ihle E., Kellner H., Schneider M., Sorensen H., Zeidler H., Sieper J.: Two year maintenance of efficacy and safety of infliximab in the treatment of ankylosing spondylitis. Ann Rheum Dis 2005;64:229—234.

13. Baraliakos X., Listing J., Fritz C. et al. Persistent clinical efficacy and safety of anti-TNF-α therapy with infliximab in patients with ankylosing spondylitis over 8 years. Ann Rheum Dis 2009;68(Suppl. 3):634.

14. Van den Bosch F, Kruithof E, Baeten D, et al. Effects of a loading dose regimen of three infusions of chimeric monoclonal antibody to tumour necrosis factor alpha (infliximab) in spondyloarthropathy:an open pilot study. Ann Rheum Dis 2000;59:428—33.

15. Braun J., Bollow M., Sieper J. Radiology and pathology of the spondyloarthropathies. Rheum Dis Clin North Am 1998;24:697—735.

16. Braun J., Davis J., Dougados M. et al. First update of the international ASAS consensus statement for the use of anti-TNF agents in patients with ankylosing spondylitis. Ann Rheum Dis 2006;65:316—24.

17. Braun J., Davis J., Dougados M. et al. First update of the international ASAS consensus statement for the use of anti-TNF agents in patients with ankylosing spondylitis. Ann Rheum Dis 2006;65:316—20.

18. Braun J, van den Berg R, Baraliakos X, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2011; 70:896—904.

19. Румянцева О. А., Бочкова А.Г., Логинова Е.Ю. и др. Исследование эффективности, безопасности и переносимости инфликсимаба у больных анкилозирующим спондилитом (предварительные результаты). Науч-практич ревматол 2006;4:11—20.

20. Alkli F, Brebаn M, Procher R, Millefert JF, Dougdos M, Roux C. Inarase in bone mineral density of patients with spondyloаrthropаthy tinted with аnti-tumor necrosis fаctor. Ann Rheum Dis 2003;63:347—9.

21. Kallenberg C.G.M. et al. Bone turnover and predictors of response in аnkylosing spondylitis results from the GLAS study. Arthritis Res Ther. 2012;14:R98.

22. Visvаnаthаn S., vаn der Heijde D., Deodhаr A., Wаgner C., Bаker DG., Hn J., Brun J: Effect of infliximab markers on inflamation and bone turnover and associations with bone mineral density in patients with аnkylosing spondylitis. Ann Rheum Dis 2009;68:175—182.

23. Van der Linden S., Valkenburg H., Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for modification of the New York criteria. Arthr Rheum 1984;27:361—8.

24. Dougados М., Paternotte S., Braun J. et al. ASAS recommendations for collecting, analysing and reporting NSAID intake in clinical trials/epidemiological studies in axial spondyloarthritis. Ann Rheum Dis 2011;70:249—51.

25. Остеопороз. Диагностика, профилактика и лечение. Клинические рекомендации. Под ред. Л.И. Беневоленской, О.М. Лесняк. М.: ГЭОТАР-Медиа, 2011;14.

26. Мясоутова Л.И., Лапшина С.А., Салихов И.Г, Васильев А.Г. Изменение минеральной плотности костной ткани у больных анкилозирующим спондилоартритом. Остеопороз и остеопатии 2011;3:14—18.


Review

For citations:


Raskina T.A., Pirogova O.A. THE INFLUENCE OF INFLIXIMAB THERAPY ON BONE MINERAL DENSITY IN PATIENTS WITH ANKYLOSING SPONDYLITIS. Osteoporosis and Bone Diseases. 2013;16(3):13-16. (In Russ.) https://doi.org/10.14341/osteo2013313-16

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