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Effects of anti-tumor necrosis factor α agents on bone.
Kawai VK, Stein CM, Perrien DS, Griffin MR
(2012) Curr Opin Rheumatol 24: 576-85
MeSH Terms: Arthritis, Rheumatoid, Bone Diseases, Bone Remodeling, Humans, Osteoblasts, Osteoclasts, Signal Transduction, Spondylarthropathies, Tumor Necrosis Factor-alpha
Show Abstract · Added December 10, 2013
PURPOSE OF REVIEW - Tumor necrosis factor (TNF) inhibitors are effective for achieving disease control in several inflammatory diseases. Although anti-TNF agents can inhibit bone loss in vitro, their role in the prevention of clinically relevant outcomes such as osteoporosis and fractures has not been clearly established.
RECENT FINDINGS - There are many studies of the effects of TNF inhibitors on markers of bone turnover; however, few have measured bone mineral density (BMD) or fractures. Most of these studies have small sample sizes and a minority had a placebo control group. Overall these studies suggest that the antiresorptive effects of anti-TNF therapy are related to control of disease activity.
SUMMARY - The antiresorptive effects of TNF inhibitors are likely related to their anti-inflammatory properties. Studies to date have not demonstrated any advantages of TNF inhibitors over traditional nonbiologic therapies in the prevention of bone loss and fractures.
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