Article

The aim was to access the effects of treatment on bone mineral
density (BMD) by treatment agents in patients with ankylosing spondylitis (AS).
METHODS: We analyzed clinical characteristics of 90 AS patients. Erythrocyte
sedimentation rate (ESR), C-reactive protein (CRP) and x-ray of lumbar spine
(L-spine) and sacroiliac joint were included in the baseline assessment. The BMDs
of right femur and L-spine were measured annually using dual x-ray absorptiometry
(DXA). The patients were divided into one of the following four groups by agents
exposed for the follow-up period: conventional treatment, bisphosphonate,
anti-TNF-alpha agent or bisphosphonate + anti-TNF-alpha agent. We evaluated the
changes of BMD according to treatment groups. RESULTS: The average age of disease
onset was 30 years and the mean disease duration was 8.2 years. The patients who
were assigned to the groups of conventional treatment, bisphosphonate,
anti-TNF-alpha agents and bisphosphonate + anti-TNF-alpha agents were 40, 20, 19
and 11. BMDs values of both L-spine and femur showed tendencies to the most
increase in the group treated with concurrent bisphosphonate and anti-TNF-alpha
agent. However, the change of BMD by treatment agents was significant different
only in trochanter (P = 0.001). In patients without syndesmophyte, there was
significant difference of BMD change in both L-spine and total proximal femur (P
= 0.001, 0.004). The BMD change of trochanter was correlated with the reductions
of ESR and CRP (r = 0.239, P = 0.035 and r = 0.233, P = 0.040). CONCLUSIONS: The
BMDs of AS patients increased more by the treatment of concurrent bisphosphonate
and anti-TNF-alpha agents. The gain of bone mass was associated with the
reduction of inflammation.
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Langue : ANGLAIS