There is an improvement in the formation of bone and a reduction in bone resorption markers with the use of the anti-tumor necrosis factor-alpha (anti-TNF-alpha) drug infliximab in patients with rheumatoid arthritis (RA) whose disease has not responded to standard therapy.
The formation/resorption ratio "suggests beneficial systemic and local bone effects of infliximab in patients with RA," French investigators report in the March issue of the Annals of the Rheumatic Diseases.
RA is associated with systemic bone loss, subchondral bone erosion and cartilage degradation caused by pro-inflammatory cytokines, including tumour necrosis factor-alpha (TNF-alpha).
Dr. Thierry Thomas of the University Hospital of Saint-Etienne and colleagues administered the anti-TNF-alpha monoclonal antibody to 48 women who had severe RA for a mean of 11.4 years. Infliximab was started after failure of other disease-modifying antirheumatic drugs and investigators measured biochemical markers of bone turnover at baseline and after 6, 22 and 54 weeks.
Bone mineral density (BMD) remained stable over 1 year. Serum cathepsin K levels, a marker of cartilage degradation, rapidly decreased by 19% at week 6 and 28% at week 22. However, by week 54, the marker returned to pre-treatment levels.
In contrast, the marker for matrix metalloprotease levels progressively declined to a maximum of 25% decrease at week 54.
"In summary, the improvement in the formation/resorption marker ratio suggests beneficial systemic and local bone effects of infliximab in patients with RA," Dr. Thomas and colleagues note.
Studies are planned to determine if the biochemical changes translate to true positive structural effects on bone with infliximab therapy.
Ann Rheum Dis 2008;67:353-357.
Would remicade be a better choice for an RA patient that is experiencing bone loss due to osteoporosis? Sorry, I missed this yesterday. That is a very good question...One I think I would be asking my RD about if I was experiencing bone loss due to osteoporosis.My mother has RA and had been on Cortisone for a number of years. It was hard to watch her suffering from this condition and the drugs were making her sick and her hair was also thinning and falling out as a side affect. I heard about a all natural product through a friend that had helped her mother. It was called Mums Rub (conveniently named :) I found out that I can order it online from www.mumsrub.com . She used it for a week and the pain had gone. She is now weaning herself off the Cortisone and has made a miracle recovery. The doctor was amazed and so was I. Just wanted to share this with you and I hope it can help you to. All the best.
my doctor has me on remicade took me off of fosamx because i have the loose stool problem. i wonder if he knew about this? how cool! he originally said my bones were worse than a 90 year old ladies bones, that was like 10 years ago i am 47.
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