Treatment with adalimumab may halt general bone loss in patients with RA, research shows

Study data show that treatment with adalimumab may inhibit the progression of general bone loss in patients with rheumatoid arthritis, unlike conventional disease-modifying antirheumatic drug therapy.

Fifty patients with active RA who initiated treatment with adalimumab 40 mg every 2 weeks were included in the prospective, open-label study, the goal of which was to explore the effects of tumor necrosis factor blockade on BMD in patients with RA. The participants were all on a...

Study data show that treatment with adalimumab may inhibit the progression of general bone loss in patients with rheumatoid arthritis, unlike conventional disease-modifying antirheumatic drug therapy.

Fifty patients with active RA who initiated treatment with adalimumab 40 mg every 2 weeks were included in the prospective, open-label study, the goal of which was to explore the effects of tumor necrosis factor blockade on BMD in patients with RA. The participants were all on a stable methotrexate regimen and were permitted to use concomitant prednisone in doses of <=10 mg/day. They also were permitted to continue taking anti-osteoporotic agents.

Bone mineral density (BMD) of the lumbar spine and femur neck was measured before treatment was initiated and 1 year later.

The investigators found that the participants' mean 28-item Disease Activity Score decreased from 5.4 at baseline to 3.6 at 16 weeks and 3.4 at week 52 (P<.001 for both). Additionally, based on European League Against Rheumatism response criteria, there were 23 good, 16 moderate, and 7 nonresponders at week 52.

At baseline, the participants' mean lumbar spine BMD was 0.962 g/cm2 and their mean femoral neck BMD was 0.798 g/cm2. These values did not change significantly after 1 year of adalimumab therapy (0.965 g/cm2 and 0.800 g/cm2, respectively).

Increases in femur neck BMD after 1 year were significantly associated with decreases in serum C-reactive protein levels at week 16 (P=.040). The association between decreases in CRP levels at week 52 and increases in femur neck BMD at that same time point were of borderline significance (P=.052).

The authors noted that the results were limited by the design of the study, which may not have been sufficiently powered to detect changes in BMD. They remarked, however, that inhibition of BMD loss with infliximab has been demonstrated previously in patients with RA or ankylosing spondylitis and that "this is the first study to show progressive general bone loss may also be arrested by adalimumab therapy."

The study was supported by Abbott.

These findings were published online April 13 ahead of print in the Annals of the Rheumatic Diseases by Wijbrandts CA, et al.