The change of bone mineral density according to treatment agents in patients with ankylosing spondylitis - 08/03/11
, Kwan Yong Lee b , Seung-Ki Kwok b , Ji Hyeon Ju b , Kyung-Soo Park b , Yeon Sik Hong b , Ho-Youn Kim b , Sung-Hwan Park b, ⁎ 
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Abstract |
Objectives |
The aim was to access the effects of treatment on bone mineral density (BMD) by treatment agents in patients with ankylosing spondylitis (AS).
Methods |
We analyzed clinical characteristics of 90 AS patients. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and x-ray of lumbar spine (L-spine) and sacroiliac joint were included in the baseline assessment. The BMDs of right femur and L-spine were measured annually using dual x-ray absorptiometry (DXA). The patients were divided into one of the following four groups by agents exposed for the follow-up period: conventional treatment, bisphosphonate, anti-TNF-⍺ agent or bisphosphonate+anti-TNF-⍺ agent. We evaluated the changes of BMD according to treatment groups.
Results |
The average age of disease onset was 30 years and the mean disease duration was 8.2 years. The patients who were assigned to the groups of conventional treatment, bisphosphonate, anti-TNF-⍺ agents and bisphosphonate+anti-TNF-⍺ agents were 40, 20, 19 and 11. BMDs values of both L-spine and femur showed tendencies to the most increase in the group treated with concurrent bisphosphonate and anti-TNF-⍺ agent. However, the change of BMD by treatment agents was significant different only in trochanter (P=0.001). In patients without syndesmophyte, there was significant difference of BMD change in both L-spine and total proximal femur (P=0.001, 0.004). The BMD change of trochanter was correlated with the reductions of ESR and CRP (r=0.239, P=0.035 and r=0.233, P=0.040).
Conclusions |
The BMDs of AS patients increased more by the treatment of concurrent bisphosphonate and anti-TNF-⍺ agents. The gain of bone mass was associated with the reduction of inflammation.
Le texte complet de cet article est disponible en PDF.Keywords : Ankylosing spondylitis, Osteoporosis, Anti-TNF-⍺ agent, Bisphosphonate, Inflammation
Plan
Vol 78 - N° 2
P. 188-193 - mars 2011 Retour au numéro
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