This article is more than 5 years old. Information may no longer be current.
Anti-TNF-a therapy may improve bone density, structure in children with Crohn’s disease
Click Here to Manage Email Alerts
Children and adolescents with Crohn’s disease who received anti-tumor necrosis factor-alpha therapy showed rapid improvement in trabecular bone mineral density and cortical structure besides improvements in disease activity, according to research in The Journal of Clinical Endocrinology & Metabolism.
The 12-month prospective cohort study also showed a significant increase in bone biomarker levels, which were strongly linked to improvements seen in bone density, structure and height, according to researchers.
Lindsay M. Griffin, MD, of the department of radiology at New York University School of Medicine, and colleagues at other institutions analyzed data from 74 children and young adults (aged 5 to 21 years) with Crohn’s disease who received Remicade (infliximab, Janssen Biotech) or a similar biologic therapy during a 12-month period at The Children’s Hospital of Philadelphia. Researchers performed tibia peripheral quantitative CT scans at the start of anti-tumor necrosis factor-alpha (anti-TNF-a) therapy and again 12 months later. Researchers expressed musculoskeletal outcomes as sex- and race-specific z scores relative to age, based on data from more than 650 healthy children participating in a larger bone health study as reference.
Trabecular BMD z scores increased an average of 0.47 during the 12 months, although there were still significant deficits at the end of the study, according to researchers. Younger age (P < .001) and greater declines in disease activity (P = .03) were associated with a greater increase in trabecular BMD z score.
Cortical area z scores also improved as endocortical circumference z scores decreased (both P < .001).
“Periosteal circumference z scores did not improve, and, as a result, cortical area z score deficits only partially corrected,” the researchers wrote.
Bone biomarker z scores increased significantly during 10 weeks, with a median change of 22% for C-terminal telopeptide of type 1 collagen (beta-CTX) and 75% for bone-specific alkaline phosphatase (BSAP). Those increases were linked to 12-month increases in height (P < .0001 for BSAP; P < .001 for beta-CTX) , trabecular BMD (P < .001 for BSAP; P < .01 for beta-CTX) and cortical area z scores (P < .001 for BSAP; P < .01 for beta-CTX) and with decreases in cortical BMD (P < .0001 for BSAP; P < .0001 for beta-CTX) and endocortical circumference z scores (P < .0001 for BSAP; P < .0001 for beta-CTX).
“These data suggest childhood provides a window of opportunity for recovery of trabecular and endocortical deficits,” the researchers wrote.
Future studies are needed to determine the impact on fracture risk, according to researchers. – by Regina Schaffer
Disclosure: Griffin reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts