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Bone and TNF in rheumatoid arthritis: clinical implications

Maria Manara1, Luigi Sinigaglia1

  • 1Department of Rheumatology , Gaetano Pini Institute , Milan , Italy.

RMD Open
|November 12, 2015
PubMed

Insights

Tumor necrosis factor (TNF) inhibitors help reduce bone loss and joint damage in rheumatoid arthritis (RA). However, evidence for their effectiveness in preventing fractures remains limited.

Area of Science:

  • Rheumatology
  • Immunology
  • Bone Metabolism

Background:

  • Tumor necrosis factor (TNF) is implicated in bone loss associated with rheumatoid arthritis (RA).
  • TNF inhibitors are used to manage RA, impacting systemic and local bone loss.

Purpose of the Study:

  • To evaluate the clinical effectiveness of TNF inhibitors in rheumatoid arthritis, focusing on bone loss and fracture prevention.
  • To compare the efficacy of TNF inhibitors against methotrexate in reducing radiographic progression in RA patients.

Main Methods:

  • Analysis of clinical trial data on TNF inhibitors in RA patients.
  • Review of observational studies assessing anti-TNF therapy outcomes.
  • Assessment of bone mineral density and bone turnover markers.
  • Evaluation of radiographic progression and joint damage evolution.

Main Results:

  • TNF inhibitors effectively arrested systemic bone loss, as indicated by bone mineral density and turnover markers.
  • Limited evidence exists for a clinically significant effect of TNF inhibition on fracture prevention.
  • Randomized clinical trials demonstrated higher efficacy of TNF inhibitors in reducing radiographic progression compared to methotrexate.
  • Observational studies support the effectiveness of anti-TNF therapy in mitigating joint damage progression.

Conclusions:

  • TNF inhibitors are effective in managing bone loss and radiographic progression in rheumatoid arthritis.
  • Further research is needed to establish the role of TNF inhibitors in fracture prevention in RA patients.
Keywords:
Bone Mineral DensityRheumatoid ArthritisTNF-alpha

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