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: 1354

The Effect of 8 Years of TNF-α Blocking Therapy on Bone Mineral Density in Patients with Ankylosing Spondylitis

Mark Siderius1, Freke Wink1, Anneke Spoorenberg1 and Suzanne Arends1, 1University Medical Centre Groningen and Medical centre Leeuwarden, Groningen, Netherlands

Meeting: ACR Convergence 2020

Keywords: Ankylosing spondylitis (AS), Anti-TNF Drugs, Bone density, longitudinal studies, Spondylarthropathies

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

Date: Sunday, November 8, 2020

Title: Spondyloarthritis Including Psoriatic Arthritis – Treatment Poster III

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

Ankylosing spondylitis (AS) is a chronic inflammatory disease that mainly affects the axial skeleton. Bone loss reflected by low bone mineral density (BMD) is a common feature of AS and can already be observed at early stages of the disease. A recent cohort study of 135 AS patients reported 7.2% improvement in lumbar spine BMD and 2.2% improvement in hip BMD after 4 years of tumor necrosis factor-alpha (TNF-α) blocking therapy.1 The objective of this study was to assess the effect of 8 years of TNF-α blocking therapy on BMD of the lumbar spine and hip in AS patients.

Methods:

Included in this study were consecutive AS outpatients from the Groningen-Leeuwarden Axial SpA (GLAS) cohort who received TNF-α blocking therapy for at least 8 years. A maximum of one switch to another TNF-α inhibitor was allowed. Patients were excluded when they used bisphosphonates at baseline or during follow-up. BMD of the lumbar spine (anterior-posterior projection L1-L4) (LS-BMD) and hip (total proximal femur) (hip-BMD) was measured at baseline, 1 year, 2 years and then bi-annually using dual-energy X-ray absorptiometry (Hologic QDR Discovery (UMCG) or Hologic QDR Delphi (MCL), Waltman, MA, USA). Z-scores, the number of SD from the normal mean corrected for age and gender, were calculated using the NHANES reference database. Low BMD was defined as lumbar spine and/or hip BMD Z-score ≤1. Generalized estimating equations were used to analyze BMD over time within subjects. Pairwise contrast were used to compare baseline and follow-up visits. P values < 0.05 were considered statistically significant.

Results:

In total, 131 AS patients were included; 73% were male, 83% HLA-B27+, mean age was 41.3 ± 10.8 years, median symptom duration 14 years (IQR 7-24), median CRP levels 13 mg/L (IQR 6-22), and 28% had poor vitamin 25(OH)D3 status (< 50) at baseline. 27% of patients switched to a second TNF-α inhibitor during follow-up and disease activity improved significantly during treatment: mean ASDASCRP 3.8 ± 0.8 at baseline and 2.1 ± 0.9 after 8 years (P< 0.001).

At baseline, low BMD at the lumbar spine and hip was present in 34% and 19% patients, respectively. Both LS-BMD and hip BMD Z-scores were significantly improved during TNF-α blocking therapy at all follow-up visits compared to baseline. Significant improvement compared to the previous time point was found up to and including 4 years for the lumbar spine and up to and including 2 years for the hip. Thereafter, flattening of improvement was observed. Median percentage of improvement in absolute BMD after 8 years of TNF-α blocking therapy compared to baseline was 7.1% (IQR 0.8-13.5) for the lumbar spine and 1.6% (IQR -3.5-5.5) for the hip (Figure 1).

Conclusion:

In AS patients with established disease, both lumbar spine and hip BMD improved significantly at group level during 8 years of TNF-α blocking therapy. This effect was most pronounced in the lumbar spine, which corresponds to the disease process in AS. Main improvements in lumbar spine BMD were observed during the first 4 years of treatment.

References:

1. Beek et al. J Bone Miner Res. 2019; jun;34(6):1041-8


Disclosure: M. Siderius, None; F. Wink, Abbvie, 5, Janssen, 5; A. Spoorenberg, Pfizer, 1, 2, Novartis, 1, 2, Abbvie pharmaceuticals, 1, 2, MSD, 1, UCB, 1; S. Arends, Pfizer, 2.

To cite this abstract in AMA style:

Siderius M, Wink F, Spoorenberg A, Arends S. The Effect of 8 Years of TNF-α Blocking Therapy on Bone Mineral Density in Patients with Ankylosing Spondylitis [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/the-effect-of-8-years-of-tnf-%ce%b1-blocking-therapy-on-bone-mineral-density-in-patients-with-ankylosing-spondylitis/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-effect-of-8-years-of-tnf-%ce%b1-blocking-therapy-on-bone-mineral-density-in-patients-with-ankylosing-spondylitis/

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