Effects of anti-tumor necrosis factor α agents on bone.

Kawai VK, Stein CM, Perrien DS, Griffin MR
Curr Opin Rheumatol. 2012 24 (5): 576-85

PMID: 22810364 · PMCID: PMC3753172 · DOI:10.1097/BOR.0b013e328356d212

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.

MeSH Terms (9)

Arthritis, Rheumatoid Bone Diseases Bone Remodeling Humans Osteoblasts Osteoclasts Signal Transduction Spondylarthropathies Tumor Necrosis Factor-alpha

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