Does the Antitumor Necrosis Factor-α Therapy Decrease the Vertebral Fractures Occurrence in Inflammatory Bowel Disease?
Adolescent
Adult
Aged
Bone Density
Bone Remodeling
Child
Cohort Studies
Female
Femur Neck
/ diagnostic imaging
Humans
Incidence
Inflammatory Bowel Diseases
/ complications
Longitudinal Studies
Lumbar Vertebrae
/ diagnostic imaging
Male
Middle Aged
Osteoporosis
/ diagnostic imaging
Osteoporotic Fractures
/ epidemiology
Prospective Studies
Spinal Fractures
/ epidemiology
Treatment Outcome
Tumor Necrosis Factor Inhibitors
/ therapeutic use
Young Adult
Vertebral fractures
anti-TNF-α therapy
bone mineral density
bone remodeling
inflammatory bowel disease
Journal
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
ISSN: 1094-6950
Titre abrégé: J Clin Densitom
Pays: United States
ID NLM: 9808212
Informations de publication
Date de publication:
Historique:
received:
24
04
2018
revised:
20
07
2018
accepted:
24
07
2018
pubmed:
13
9
2018
medline:
26
6
2020
entrez:
13
9
2018
Statut:
ppublish
Résumé
Osteoporosis and osteoporotic fracture risk are extraintestinal manifestations of the inflammatory bowel disease, whose etiopathogenic mechanisms have not been determined yet. Anti-tumor necrosis factor (TNF)-α are used in treatment of inflammatory bowel disease (IBD), but it is unknown if they play a role in osteoporotic fracture prevention. The objective of this study was to know if anti-TNF decreases fracture risk or modifies bone mineral density. To determine the possible risk factors associated with fractures, and assess the incidence of vertebral fractures in IBD patients. Longitudinal prospective cohort study (7 yr of follow-up); which included 71 IBD patients, 23 received anti-TNF-α; the remaining 48 received conventional treatment, constituted the control group. Patients participated in a questionnaire which gathered risk factors associated with the development of osteoporosis and fractures. Radiographs of the dorsolumbar-spine were performed and also a bone density measurement. Their biochemical and bone remodeling parameters were determined. Although patients who did not receive anti-TNF-α, suffered more fractures but biologic therapy did not reduce the risk of new vertebral fractures. The increase of bone mass was significantly higher the group treated with anti-TNF-α. The increase in the lumbar spine was of 8% and in the femoral neck was of 6.7%. The only determinant factor for the incidence of vertebral fractures was a history of previous fractures (odds ratio of 12.8; confidence interval 95% 2.37-69.9; p = 0.003). The incidence of vertebral fractures in IBD patients was considerably high: 26.7/700 patient-yr. Anti-TNF-α, although increased bone mass in these patients, did not reduce the risk of new vertebral fractures. In this study, patients with IBD have a considerably high incidence of fractures. Only the existence of previous vertebral fractures was a predictive factor for consistent fractures.
Sections du résumé
BACKGROUND/OBJECTIVE
Osteoporosis and osteoporotic fracture risk are extraintestinal manifestations of the inflammatory bowel disease, whose etiopathogenic mechanisms have not been determined yet. Anti-tumor necrosis factor (TNF)-α are used in treatment of inflammatory bowel disease (IBD), but it is unknown if they play a role in osteoporotic fracture prevention. The objective of this study was to know if anti-TNF decreases fracture risk or modifies bone mineral density. To determine the possible risk factors associated with fractures, and assess the incidence of vertebral fractures in IBD patients.
METHODS
Longitudinal prospective cohort study (7 yr of follow-up); which included 71 IBD patients, 23 received anti-TNF-α; the remaining 48 received conventional treatment, constituted the control group. Patients participated in a questionnaire which gathered risk factors associated with the development of osteoporosis and fractures. Radiographs of the dorsolumbar-spine were performed and also a bone density measurement. Their biochemical and bone remodeling parameters were determined.
RESULTS
Although patients who did not receive anti-TNF-α, suffered more fractures but biologic therapy did not reduce the risk of new vertebral fractures. The increase of bone mass was significantly higher the group treated with anti-TNF-α. The increase in the lumbar spine was of 8% and in the femoral neck was of 6.7%. The only determinant factor for the incidence of vertebral fractures was a history of previous fractures (odds ratio of 12.8; confidence interval 95% 2.37-69.9; p = 0.003). The incidence of vertebral fractures in IBD patients was considerably high: 26.7/700 patient-yr.
CONCLUSIONS
Anti-TNF-α, although increased bone mass in these patients, did not reduce the risk of new vertebral fractures. In this study, patients with IBD have a considerably high incidence of fractures. Only the existence of previous vertebral fractures was a predictive factor for consistent fractures.
Identifiants
pubmed: 30205986
pii: S1094-6950(18)30073-8
doi: 10.1016/j.jocd.2018.07.010
pii:
doi:
Substances chimiques
Tumor Necrosis Factor Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
195-202Informations de copyright
Copyright © 2018 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.