PMID- 30205986
OWN - NLM
STAT- In-Data-Review
LR  - 20190416
IS  - 1094-6950 (Print)
IS  - 1094-6950 (Linking)
VI  - 22
IP  - 2
DP  - 2019 Apr - Jun
TI  - Does the Antitumor Necrosis Factor-alpha Therapy Decrease the Vertebral Fractures
      Occurrence in Inflammatory Bowel Disease?
PG  - 195-202
LID - S1094-6950(18)30073-8 [pii]
LID - 10.1016/j.jocd.2018.07.010 [doi]
AB  - BACKGROUND/OBJECTIVE: Osteoporosis and osteoporotic fracture risk are
      extraintestinal manifestations of the inflammatory bowel disease, whose
      etiopathogenic mechanisms have not been determined yet. Anti-tumor necrosis
      factor (TNF)-alpha are used in treatment of inflammatory bowel disease (IBD), but
      it is unknown if they play a role in osteoporotic fracture prevention. The
      objective of this study was to know if anti-TNF decreases fracture risk or
      modifies bone mineral density. To determine the possible risk factors associated 
      with fractures, and assess the incidence of vertebral fractures in IBD patients. 
      METHODS: Longitudinal prospective cohort study (7 yr of follow-up); which
      included 71 IBD patients, 23 received anti-TNF-alpha; the remaining 48 received
      conventional treatment, constituted the control group. Patients participated in a
      questionnaire which gathered risk factors associated with the development of
      osteoporosis and fractures. Radiographs of the dorsolumbar-spine were performed
      and also a bone density measurement. Their biochemical and bone remodeling
      parameters were determined. RESULTS: Although patients who did not receive
      anti-TNF-alpha, suffered more fractures but biologic therapy did not reduce the
      risk of new vertebral fractures. The increase of bone mass was significantly
      higher the group treated with anti-TNF-alpha. The increase in the lumbar spine
      was of 8% and in the femoral neck was of 6.7%. The only determinant factor for
      the incidence of vertebral fractures was a history of previous fractures (odds
      ratio of 12.8; confidence interval 95% 2.37-69.9; p=0.003). The incidence of
      vertebral fractures in IBD patients was considerably high: 26.7/700 patient-yr.
      CONCLUSIONS: Anti-TNF-alpha, although increased bone mass in these patients, did 
      not reduce the risk of new vertebral fractures. In this study, patients with IBD 
      have a considerably high incidence of fractures. Only the existence of previous
      vertebral fractures was a predictive factor for consistent fractures.
CI  - Copyright (c) 2018 The International Society for Clinical Densitometry. Published
      by Elsevier Inc. All rights reserved.
FAU - Maldonado-Perez, M B
AU  - Maldonado-Perez MB
AD  - Department of Gastroenterology, University Hospital Virgen Macarena, Seville,
      Spain. Electronic address: bmalpe@hotmail.com.
FAU - Castro-Laria, L
AU  - Castro-Laria L
AD  - Department of Gastroenterology, University Hospital Virgen Macarena, Seville,
      Spain.
FAU - Caunedo-Alvarez, A
AU  - Caunedo-Alvarez A
AD  - Department of Gastroenterology, University Hospital Virgen Macarena, Seville,
      Spain; Medicine Department, University of Seville, Seville, Spain.
FAU - Montoya-Garcia, M J
AU  - Montoya-Garcia MJ
AD  - Medicine Department, University of Seville, Seville, Spain; Bone Metabolism Unit,
      University Hospital Virgen Macarena, Seville, Spain.
FAU - Giner-Garcia, M
AU  - Giner-Garcia M
AD  - Medicine Department, University of Seville, Seville, Spain; Bone Metabolism Unit,
      University Hospital Virgen Macarena, Seville, Spain.
FAU - Arguelles-Arias, F
AU  - Arguelles-Arias F
AD  - Department of Gastroenterology, University Hospital Virgen Macarena, Seville,
      Spain; Medicine Department, University of Seville, Seville, Spain.
FAU - Romero-Gomez, M
AU  - Romero-Gomez M
AD  - Department of Gastroenterology, University Hospital Virgen Macarena, Seville,
      Spain; Medicine Department, University of Seville, Seville, Spain.
FAU - Vazquez-Gamez, M A
AU  - Vazquez-Gamez MA
AD  - Medicine Department, University of Seville, Seville, Spain; Bone Metabolism Unit,
      University Hospital Virgen Macarena, Seville, Spain.
LA  - eng
PT  - Journal Article
DEP - 20180813
PL  - United States
TA  - J Clin Densitom
JT  - Journal of clinical densitometry : the official journal of the International
      Society for Clinical Densitometry
JID - 9808212
SB  - IM
OTO - NOTNLM
OT  - Vertebral fractures
OT  - anti-TNF-alpha therapy
OT  - bone mineral density
OT  - bone remodeling
OT  - inflammatory bowel disease
EDAT- 2018/09/13 06:00
MHDA- 2018/09/13 06:00
CRDT- 2018/09/13 06:00
PHST- 2018/04/24 00:00 [received]
PHST- 2018/07/20 00:00 [revised]
PHST- 2018/07/24 00:00 [accepted]
PHST- 2018/09/13 06:00 [pubmed]
PHST- 2018/09/13 06:00 [medline]
PHST- 2018/09/13 06:00 [entrez]
AID - S1094-6950(18)30073-8 [pii]
AID - 10.1016/j.jocd.2018.07.010 [doi]
PST - ppublish
SO  - J Clin Densitom. 2019 Apr - Jun;22(2):195-202. doi: 10.1016/j.jocd.2018.07.010.
      Epub 2018 Aug 13.