Journal
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
Volume 20, Issue 6, Pages 607-614Publisher
WILEY
DOI: 10.1111/j.1365-2036.2004.02152.x
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Background: Crohn's disease is associated with low bone mineral density and altered bone metabolism. Aim: To assess the evolution of bone metabolism in Crohn's disease patients treated with infliximab. Methods: We studied 71 Crohn's disease patients treated for the first time with infliximab for refractory Crohn's disease. Biochemical markers of bone formation (type-I procollagen N-terminal propeptide, bone-specific alkaline phosphatase, osteocalcin) and of bone resorption (C-telopeptide of type-I collagen) were measured in the serum before and 8 weeks after infliximab therapy and compared with values in a matched healthy control group. Results: Eight weeks after treatment with infliximab, a normalization of bone markers was observed with a median increase in formation markers of 14-51% according to marker and a lower but significant decrease in resorption marker (median 11%). A clinically relevant increase in bone formation markers was present in 30-61% of patients according to the marker. A clinically relevant decrease in C-telopeptide of type-I collagen was present in 38% of patients. No association was found with any tested demographic or clinical parameter. Conclusion: Infliximab therapy in Crohn's disease may rapidly influence bone metabolism by acting either on bone formation or bone resorption. This improvement seems to be independent of clinical response to infliximab.
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