托珠单抗在类风湿性关节炎中的保骨作用:一项单中心观察性研究。

IF 1.4 Q3 RHEUMATOLOGY Reumatologia Pub Date : 2022-01-01 Epub Date: 2022-11-04 DOI:10.5114/reum.2022.120756
Suhel Gabriele Al Khayyat, Roberto D'Alessandro, Edoardo Conticini, Serena Pierguidi, Paolo Falsetti, Caterina Baldi, Marco Bardelli, Stefano Gentileschi, Antonella Nicosia, Bruno Frediani
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引用次数: 0

摘要

骨质流失是一些自身免疫性疾病和慢性炎症性疾病的共同特征,如类风湿关节炎(RA)。事实上,高水平的促炎细胞因子似乎可以增强骨吸收并减少骨形成,从而产生破骨细胞和成骨细胞功能之间的不耦合,有利于关节旁和全身骨质疏松症的发生。许多论文强调RA中骨质疏松的高患病率,以及血清白细胞介素6 (IL-6)水平与骨密度(BMD)之间的负相关。本研究的目的是评估tocilizumab (TCZ)治疗一年的有效性,TCZ是第一个批准的IL-6受体抑制剂,用于减少RA的骨质流失。材料和方法:我们从关节炎门诊纳入了18例符合2010年ACR和EULAR标准的RA患者,在12个月的时间内评估临床和生化参数。患者每4周静脉注射TCZ 8 mg/kg,并在基线和研究结束时进行双能x线骨密度测量(DXA)。在基线、6个月和1年时测定血清c反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞介素(IL-6)、血清cross - lap、骨保护素(OPG)、核因子κβ配体受体激活剂(RANK-L)和dickkopf-1 (DKK-1)水平。结果:IL-6、RANK-L、DKK-1、OPG和血清CrossLaps水平在基线、6个月和1年之间无显著差异。治疗1年后,腰椎骨密度显著增加。研究结束时,没有记录到全身和股骨颈骨密度的差异。结论:本研究提示TCZ对RA患者有保骨作用。
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Bone-sparing effects of tocilizumab in rheumatoid arthritis: a monocentric observational study.

Introduction: Bone loss is a common feature in several autoimmune and chronic inflammatory diseases, such as rheumatoid arthritis (RA). Indeed, the high levels of pro-inflammatory cytokines seem to enhance bone resorption and to diminish bone formation, thus producing an uncoupling between osteoclast and osteoblast function and favoring the onset of juxtarticular as well as systemic osteoporosis. Many papers underline the high prevalence of osteoporosis in RA, as well as the negative correlation between interleukin 6 (IL-6) serum levels and bone mineral density (BMD). The aim of this study was to assess the effectiveness of one-year treatment with tocilizumab (TCZ), the first approved IL-6 receptor inhibitor, in reducing bone loss in RA.

Material and methods: We enrolled 18 patients fulfilling 2010 ACR and EULAR criteria for RA from our arthritis outpatient clinic, assessing clinical and biochemical parameters during a 12-month period. The patients received TCZ 8 mg/kg i.v. every 4 weeks and underwent dual energy X-ray absorptiometry (DXA) for the measurement of bone mineral density (BMD) at baseline and at the end of study. Serum levels of C-reactive protein (CRP), erythrocytes sedimentation rate (ESR), IL-6, serum CrossLaps, osteoprotegerin (OPG), receptor activator of nuclear factor κβ ligand (RANK-L) and dickkopf-1 (DKK-1) were measured at baseline, at 6 months and 1 year.

Results: No significant difference in IL-6, RANK-L, DKK-1, OPG and serum CrossLaps levels between baseline, 6 months and 1 year were found. A significant increase of lumbar spine BMD was evidenced after 1 year of TCZ treatment. No difference in total body and femoral neck BMD was documented the end of the study.

Conclusions: This study suggest the bone-sparing effect of TCZ in RA affected individuals.

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来源期刊
Reumatologia
Reumatologia Medicine-Rheumatology
CiteScore
2.70
自引率
0.00%
发文量
44
审稿时长
10 weeks
期刊最新文献
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