Influence of anti-TNF alpha treatment in bone metabolism markers

Detalhes bibliográficos
Autor(a) principal: Pereira, Sofia Inês Thumann Cardoso do Vale
Data de Publicação: 2014
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Texto Completo: https://hdl.handle.net/10316/34619
Resumo: Trabalho final de mestrado integrado em Medicina, área cientifica de Fisiopatologia/Reumatologia, apresentado á Faculdade de Medicina da Universidade de Coimbra
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spelling Influence of anti-TNF alpha treatment in bone metabolism markersMarcadores biológicosMetabolismoOsso e ossosMedicamentosDomínio/Área Científica::Ciências MédicasTrabalho final de mestrado integrado em Medicina, área cientifica de Fisiopatologia/Reumatologia, apresentado á Faculdade de Medicina da Universidade de CoimbraChronic inflammatory joint diseases are a heterogeneous group of disorders associated with local and systemic bone loss. Tumor necrosis factor alpha (TNFα), a pivotal proinflammatory cytokine common in the pathogenesis of these diseases, is known to induce bone loss by increasing osteoclast recruitment and activity. Anti-TNFα antibodies used in the treatment of inflammatory arthropaties may influence the risk of osteoporosis, by preventing bone loss. The exact mechanism of preventing bone loss has not yet clearly assessed. The main purpose of this work was to examine the fluctuation of biochemical markers of bone metabolism induced by three different anti-TNF agents (Infliximab, Etanercept and Adalimumab), taking into account their different pharmacokinetic profiles. We evaluate patients with inflammatory rheumatic diseases treated with biologics. Data on demographic characteristics, pharmacological treatment history, anti-TNF treatment duration and disease activity (Bath Ankylosing Spondylitis Disease Activity Index, BASDAI, Disease activity score for 28 joints, DAS28) were collected. Blood and urine samples were collected in the day of drug administration (day A), immediately before administration and in the estimated day of maximum plasmatic level of each drug (day I). We determined, by ELISA, serum bone-specific alkaline phosphatase (sBAP), serum osteocalcin (sOC) and urine deoxipyridinoline (uDPD) using creatinin (Cr) as a normalization factor for urine samples. Changes between days were analyzed by Paired sample T test. Statistical significance was assumed for p values <0.05. These study enrolled 58 patients (67,2% females); 35 with rheumatoid arthritis (RA) (DAS28=3.8±1.4), 17 with ankylosing spondylitis (AS) (BASDAI=3.4±2.3) and 6 with psoriatic arthritis (PsA) (DAS28=3.1±1.1), with a mean age 48,9±14 years. The average biological treatment duration was 25±16 months. Changes in biological parameters from baseline (day A) to day I were calculate and also presented graphically. We also performed ratios between formation and resorption markers (sOC/uDPDcr and sOC/uDPDcr). Our study showed an oscillation towards a decrease of DPDCr, a bone resorption marker, between the day of minimum and maximum anti-TNFα antibodies plasmatic levels mainly for infliximab and etenercept groups. Contrariwise bone formation markers (OC and BAP) showed no statistical significant changes with an exception for sBAP for the Adalimumab group. The positive change on ratio bone formation/resorption markers lead to a net bone formation, which suggest that anti-TNFα antibodies prevent osteoporosis. Further research is warranted to clarify whether fluctuations and differences are reflected in the actual osteoporosis risk in these patients.2014-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttps://hdl.handle.net/10316/34619https://hdl.handle.net/10316/34619engPereira, Sofia Inês Thumann Cardoso do Valeinfo:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2022-01-20T17:48:45Zoai:estudogeral.uc.pt:10316/34619Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T04:55:41.744541Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Influence of anti-TNF alpha treatment in bone metabolism markers
title Influence of anti-TNF alpha treatment in bone metabolism markers
spellingShingle Influence of anti-TNF alpha treatment in bone metabolism markers
Pereira, Sofia Inês Thumann Cardoso do Vale
Marcadores biológicos
Metabolismo
Osso e ossos
Medicamentos
Domínio/Área Científica::Ciências Médicas
title_short Influence of anti-TNF alpha treatment in bone metabolism markers
title_full Influence of anti-TNF alpha treatment in bone metabolism markers
title_fullStr Influence of anti-TNF alpha treatment in bone metabolism markers
title_full_unstemmed Influence of anti-TNF alpha treatment in bone metabolism markers
title_sort Influence of anti-TNF alpha treatment in bone metabolism markers
author Pereira, Sofia Inês Thumann Cardoso do Vale
author_facet Pereira, Sofia Inês Thumann Cardoso do Vale
author_role author
dc.contributor.author.fl_str_mv Pereira, Sofia Inês Thumann Cardoso do Vale
dc.subject.por.fl_str_mv Marcadores biológicos
Metabolismo
Osso e ossos
Medicamentos
Domínio/Área Científica::Ciências Médicas
topic Marcadores biológicos
Metabolismo
Osso e ossos
Medicamentos
Domínio/Área Científica::Ciências Médicas
description Trabalho final de mestrado integrado em Medicina, área cientifica de Fisiopatologia/Reumatologia, apresentado á Faculdade de Medicina da Universidade de Coimbra
publishDate 2014
dc.date.none.fl_str_mv 2014-04
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://hdl.handle.net/10316/34619
https://hdl.handle.net/10316/34619
url https://hdl.handle.net/10316/34619
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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