Table 4.

Summary of published studies for the effect of tumor necrosis factor-α inhibitors on bone mineral density in RA patients

Study, Yr	Subjects on TNFi	Mean age (yr)	Subjects on Comparator DMARD	Follow up period	Findings
Lange, 2005(23)	26 IFX	54	-	1 year	BMD increased by 12% at the femoral neck and 3% at the lumbar spine
Vis, 2005(27)	36 IFX	53	-	1 year	BMD remained stable at the spine and hip
Vis, 2006(26)	102 IFX	53	-	1 year	BMD remained stable at the spine and hip
Seriolo, 2006(25)	11 ETA and 10 IFX	51	10 MTX	6 months	BMD increased by 0.1–0.2% at the spine and hip among TNFi users and decreased by 0.6–0.8% at the spine and hip among MTX users
Marotte, 2007(44)	90 IFX	51	99 MTX	1 year	BMD decreased by 2.5–3.9% at the spine and femoral neck in the control group, but remained stable in the IFX group
Serelis, 2008(24)	7 ADA and 12 IFX	54	-	1 year	BMD remained stable at the spine
Chopin, 2008(18)	48 IFX	54	-	54 weeks	BMD remained stable at the spine
Haugeberg, 2009(20)	10 IFX	52	10 MTX	1 year	BMD loss was significantly less in the infliximab group compared with the placebo group at the femoral neck (−0.4% vs. −3.4%) and total hip (−0.2% vs. −2.6%) but not at the hand and spine
Wijbrandts, 2009(28)	52 ADA	51	-	1 year	BMD remained stable at the spine and femur neck
Hoff, 2009(22)	522 ADA	52	246 MTX	104 weeks	Hand BMD loss was lowest in the ADA plus MTX group and greatest in the MTX group (−3.0% vs. −4.6%)
Güler-Yüksel, 2009(19)	52 IFX	54	166 on other treatment	2 years	Hand BMD loss was less in the IFX group compared with other treatment only
Eekman, 2011(21)	52 IFX	60	-	3.5 years	BMD was stable at the hip, increased by 2.6% at the spine, and decreased by 3.1% in the hand
Hoff, 2011(43)	214 ADA	52	188 MTX	2 years	Hand bone loss was less in the ADA plus MTX group, independently of clinically assessed disease activity

TNFi: tumor necrosis factor-α inhibitor, BMD: bone mineral density, IFX: infliximab, ADA, adalimumab, ETA: etanercept, MTX: methotrexate, DMARD: disease-modifying antirheumatic drug