Does TNF-alpha therapy has a role in the treatment of Rheutamoid Arthritis?
TNF-alpha (tumor necrosis factor-alpha) is a naturally occurring cytokine that is involved in normal inflammatory and immune responses. TNF-alpha plays an important role in rheumatoid arthritis, ankylosing spondylitis and psoriasis. TNFα inhibitors (TNFαI) exert positive effects on disease activity in rheumatoid arthritis. However, in the last twenty years, inflammatory arthropathies treatment has improved alot with the invention of various biological drugs.
The short-term effects of TNFαI therapy on bone metabolism and bone density was investigated in a study done on 54 rheutamoid arthritis patients. In such patients, bone turnover markers i.e. N-propeptide of type I collagen (P1NP), and bone alkaline phosphates for bone formation and serum C-terminal telopeptide of type I collagen (CTX) for bone resorption were measured at baseline and after 6-month therapy. Furthermore, with the assitance of dual-energy X-ray absorptiometry, at hip and lumbar bone mineral density (BMD) was evaluated.
The findings showed significant rise in the bone markers, decrease in femoral neck BMD and these changes were not clearly based on dosage of steroid. Thus, results of this study revealed that rheutamoid arthritis patients gets benefits from this TNFαI therapy over the period of 6 months as it leads to early increase in bone turnover, but they also obeserved fall in hip bone mineral density.