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Influence of anti-TNF therapy on bone metabolism in patients with inflammatory bowel disease

Published:February 04, 2017DOI:https://doi.org/10.1016/j.ejim.2017.01.024
      Several studies conclude that patients with inflammatory bowel disease (IBD) are at an increased risk of osteoporosis (30–50%) [
      • Adachi J.D.
      • Rostom A.
      Metabolic bone disease in adults with inflammatory bowel disease.
      ] and fractures (1.3 to 2.5 times) [
      • Vestergaard P.
      • Mosekilde F.
      Fracture risk in patients with disease, Crohn's disease, and ulcerative colitis: a nationwide follow-up study of 16416 patients in Denmark.
      ]. Different factors can be implicated (intestinal malabsorption, hypogonadism, physical inactivity, use of corticoids and deficiency of vitamin D) [
      • Bernstein C.N.
      • Seeger L.L.
      • Sayre J.W.
      • Anton P.A.
      • Artinian L.
      • Shanahan F.
      Decreased bone density in inflammatory bowel disease is related to corticosteroid use and not disease diagnosis.
      ,
      • Raftery T.
      • O'Sullivan M.
      Optimal vitamin D levels in Crohn's disease: a review.
      ]. Moreover, the increase of proinflammatory cytokines, such as the tumor necrosis factor (TNF) and the interleukins (IL), also appear to be involved in the pathogenesis of bone loss in these patients [
      • Lacativa P.G.
      • Farias M.L.
      Osteoporosis and inflammation.
      ]. Although anti-TNF drugs are frequently used in patients with IBD, their influence on bone metabolism in these patients is not well known. The objective of this study was to prospectively assess the effect of TNF blockade on bone metabolism and bone mineral density (BMD).
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