Inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximab
Background/Aims We investigated the effect of rituximab on systemic bone metabolism in patients with seropositive rheumatoid arthritis (RA). Methods Twenty seropositive patients with RA were enrolled and administered one cycle of rituximab. If RA became active for > 6 months after the first ritux...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Korean Association of Internal Medicine
2023-11-01
|
| Series: | The Korean Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://www.kjim.org/upload/kjim-2023-080.pdf |
| _version_ | 1827767666878709760 |
|---|---|
| author | Mie Jin Lim Kyong-Hee Jung Seong-Ryul Kwon Won Park |
| author_facet | Mie Jin Lim Kyong-Hee Jung Seong-Ryul Kwon Won Park |
| author_sort | Mie Jin Lim |
| collection | DOAJ |
| description | Background/Aims We investigated the effect of rituximab on systemic bone metabolism in patients with seropositive rheumatoid arthritis (RA). Methods Twenty seropositive patients with RA were enrolled and administered one cycle of rituximab. If RA became active for > 6 months after the first rituximab cycle, a second cycle was initiated; otherwise, no additional treatment was administered. Patients were divided into two groups according to the number of rituximab treatment cycles. Results In patients treated with a second cycle, the total hip bone mineral density (BMD) was clinically low, whereas the serum levels of receptor activator of nuclear factor kappa-B ligand (RANKL) were increased at 12 months. BMD in patients treated with one cycle did not change at 12 months, whereas serum RANKL levels decreased at all time points. DAS28 activity improved in both groups from baseline to 4 months; however, from 4 to 12 months, DAS28 activity worsened in the group with the second cycle but remained stable in the group with one cycle. Conclusions Systemic inflammation, reflected by increased disease activity, may be responsible for the increase in RANKL levels, which causes systemic bone loss in rituximab-treated patients with RA. Although rituximab affects inflammation, it does not seem to alter systemic bone metabolism in RA. |
| first_indexed | 2024-03-11T12:01:15Z |
| format | Article |
| id | doaj.art-fb8fac31c6c54215b93fafc25ee90cd4 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-03-11T12:01:15Z |
| publishDate | 2023-11-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-fb8fac31c6c54215b93fafc25ee90cd42023-11-08T05:34:56ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482023-11-0138691292210.3904/kjim.2023.080170844Inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximabMie Jin Lim0Kyong-Hee Jung1Seong-Ryul Kwon2Won Park3Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon, KoreaDivision of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon, KoreaDivision of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon, KoreaDivision of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon, KoreaBackground/Aims We investigated the effect of rituximab on systemic bone metabolism in patients with seropositive rheumatoid arthritis (RA). Methods Twenty seropositive patients with RA were enrolled and administered one cycle of rituximab. If RA became active for > 6 months after the first rituximab cycle, a second cycle was initiated; otherwise, no additional treatment was administered. Patients were divided into two groups according to the number of rituximab treatment cycles. Results In patients treated with a second cycle, the total hip bone mineral density (BMD) was clinically low, whereas the serum levels of receptor activator of nuclear factor kappa-B ligand (RANKL) were increased at 12 months. BMD in patients treated with one cycle did not change at 12 months, whereas serum RANKL levels decreased at all time points. DAS28 activity improved in both groups from baseline to 4 months; however, from 4 to 12 months, DAS28 activity worsened in the group with the second cycle but remained stable in the group with one cycle. Conclusions Systemic inflammation, reflected by increased disease activity, may be responsible for the increase in RANKL levels, which causes systemic bone loss in rituximab-treated patients with RA. Although rituximab affects inflammation, it does not seem to alter systemic bone metabolism in RA.http://www.kjim.org/upload/kjim-2023-080.pdfbonerheumatoid arthritisrituximabrank ligandb-lymphocytes |
| spellingShingle | Mie Jin Lim Kyong-Hee Jung Seong-Ryul Kwon Won Park Inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximab The Korean Journal of Internal Medicine bone rheumatoid arthritis rituximab rank ligand b-lymphocytes |
| title | Inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximab |
| title_full | Inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximab |
| title_fullStr | Inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximab |
| title_full_unstemmed | Inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximab |
| title_short | Inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximab |
| title_sort | inflammation is responsible for systemic bone loss in patients with seropositive rheumatoid arthritis treated with rituximab |
| topic | bone rheumatoid arthritis rituximab rank ligand b-lymphocytes |
| url | http://www.kjim.org/upload/kjim-2023-080.pdf |
| work_keys_str_mv | AT miejinlim inflammationisresponsibleforsystemicbonelossinpatientswithseropositiverheumatoidarthritistreatedwithrituximab AT kyongheejung inflammationisresponsibleforsystemicbonelossinpatientswithseropositiverheumatoidarthritistreatedwithrituximab AT seongryulkwon inflammationisresponsibleforsystemicbonelossinpatientswithseropositiverheumatoidarthritistreatedwithrituximab AT wonpark inflammationisresponsibleforsystemicbonelossinpatientswithseropositiverheumatoidarthritistreatedwithrituximab |