Body Weight and Bone Density Changes in Patients with Ankylosing Spondylitis Receiving Anti-Tumor Necrosis Factor-alpha Treatment

Lee, Jangwon; Jung, Minsuk; Kim, Donghyun; Lee, Seunghyun; Oh, Sook Kyung; Jo, Youngsun; Byun, Sanghwan; Nam, Kyoungmin; Lee, Choongwon

Abstract

BACKGROUND/AIMS
To determine the changes in body weight and bone mineral density in patients with ankylosing spondylitis (AS) receiving anti-tumor necrosis factor-alpha (TNF-alpha) treatment.
METHODS
Thirty-one patients with AS (25 males and 6 females) who fulfilled the Modified New York Criteria for AS were included in this retrospective study. All patients had active disease that eventually required anti-TNF-alpha treatment. Each patient received anti-TNF-alpha treatment (etanercept 25 mg twice weekly or adalimumab 40 mg twice monthly) for more than 2 years. Body weight, disease activity as Bath ankylosing spondylitis disease activity index (BASDAI), C-reactive protein, erythrocyte sedimentation rate (ESR), lumbar bone mineral density (LBMD), and femoral bone mineral density (FBMD) were measured at baseline and at 1 and 2 years after initiating anti-TNF-alpha treatment.
RESULTS
There was a significant increase in mean body weight at 1 year (1.1 +/- 3.8 kg) and at 2 years (1.7 +/- 4.8 kg) compared with baseline. The gains in mean BMD of the lumbar spine were significant at 1 year (0.4 +/- 0.4) and 2 years (0.5 +/- 0.7) compared with baseline. Mean BMD of the femur was also increased at 1 year (0.08 +/- 0.7) and 2 years (0.1 +/- 0.8) compared with baseline, but these differences were not statistically significant. There were significant decreases in BASDAI at 1 year (-3.3 +/- 2.8) and at 2 years (-3.6 +/- 2.8) compared with baseline.
CONCLUSIONS
This study showed significant increases in body weight, lumbar BMD, and BASDAI at 1 year and 2 years in patients with ankylosing spondylitis after receiving anti-TNF-alpha treatment.