ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1992

Anti-TNF Therapies Improve Bone Mineral Density At the Lumbar Spine of RA Patients by Decreasing Disease Activity and Suppressing Serum RANKL Levels

Allen P. Anandarajah1, Jennifer Hossler2, Kate Burns3, Kelly Callahan3, Yahui Grace Chiu3 and Jennifer H. Anolik4, 1Dept of Rheumatology, Univ of Rochester Medical Ctr, Rochester, NY, 2Rheumatology, University of Rochester, Rochester, NY, 3Allergy, Immunology and Rheumatology, University of Rochester, Rochester, NY, 4Medicine- Allergy, Immunology and Rheumatology, University of Rochester, Rochester, NY

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Bone density, RANK/RANKL pathway, rheumatoid arthritis (RA) and tumor necrosis factor (TNF)

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Title: Osteoporosis and Metabolic Bone Disease

Session Type: Abstract Submissions (ACR)

Background/Purpose: Generalized bone loss (osteoporosis or osteopenia) is more common in patients with rheumatoid arthritis (RA) than in the general population. Recent studies suggest that inflammation in RA is a main contributor to this form of bone loss. Inflammation is mediated in turn by multiple cytokines with tumor necrosis factor (TNF) being a key player. Few studies, however, have described the effects of anti-TNF therapies on generalized bone loss.

Objective: To study the effects of anti-TNF therapies on the bone mineral density (BMD) of early RA patients and to correlate the BMD measurements with serum receptor activator of NFkB ligand (RANKL) and osteprotegerin (OPG).

Methods:  This is a single center study of 40 subjects with active RA (disease activity scores of 3.2 or more) that are naïve to anti-TNF therapy and receiving stable doses of disease-modifying drugs. Patients were treated with adalimumab 40 mg every other week or etanercept (25 mg twice a week or 50 mg once a week). Subjects were allowed to be on a maximum daily dose of 10 mg of prednisone or an equivalent dose. Subjects did not require or were not willing to take medications for osteoporosis.  DAS28 assessments were done at baseline, 12 and 24 weeks. Bone mineral density (BMD) measurements of the lumbar spine (LS) and hips were done using a Lunar Prodigy x-ray absorptiometer prior to the first dose of anti-TNF therapy and at week 52. Serum RANKL and OPG levels were measured by ELISA at baseline and at weeks 24 and 52.

Results: The 8 subjects (females, 5; males, 3) who have completed 1 year of anti-TNF therapy had a mean age of 57 years. The mean DAS28 score improved from 4.8 at baseline to 3.5 at 24 weeks. Five patients had a good DAS28 response, 2 had a moderate response, and 1 was a non-responder. The BMD at the LS increased in 5, decreased in 2, and did not change in 1. The mean BMD for the group as a whole did not change with treatment (1.22g/cm2 to 1.21g/cm2) between baseline and week 52. Among the 5 patients with an increase in BMD, 4 had had a good DAS28 response and one had a moderate DAS28 response; whereas, among the 2 patients with a decrease in BMD, 1  was a DAS28 non-responder and 1 had  had a good DAS28 response. The patient with no significant change in BMD had a moderate DAS28 response. Serum RANKL levels decreased significantly with treatment from 2381 pg/ml (+/- 3025) at baseline to 921 pg/ml (+/- 1630) at week 52 (p=0.03). Interestingly, at 24 weeks, the serum RANKL was decreased in those with improved BMD (mean RANKL 1994.4 pg/ml at baseline and 1298.2pg/ml at week 24), but was essentially unchanged in those with decreased/ unchanged BMD (mean RANKL 3025.7 pg/ml at baseline and 3029.7 pg/ml at week 24). In the 5 subjects with increased BMD, RANKL levels were decreased in 4 of the subjects and increased in 1 subject.  Among the 2 patients with a decrease in BMD, 1 had an increase and 1 had a decrease in RANKL levels. The remaining subject with  no change in BMD also had no change in RANKL level. No relationship was noted between BMD at the LS and OPG levels.

Conclusion: Anti-TNF therapy improves BMD at the lumbar spine in a subset of RA patients. The increase in BMD is associated with a decrease in disease activity and may be mediated by a suppression of serum RANKL levels.


Disclosure:

A. P. Anandarajah,

Abbott Immunology Pharmaceuticals,

8;

J. Hossler,
None;

K. Burns,
None;

K. Callahan,
None;

Y. G. Chiu,
None;

J. H. Anolik,
None.

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/anti-tnf-therapies-improve-bone-mineral-density-at-the-lumbar-spine-of-ra-patients-by-decreasing-disease-activity-and-suppressing-serum-rankl-levels/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology