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Vol. 24, No. 1-2, 2006
Issue release date: May 2006
Dig Dis 2006;24:201–206

Infliximab Therapy Improves the Bone Metabolism in Fistulizing Crohn’s Disease

Miheller P. · Müzes G. · Zagoni T. · Toth M. · Racz K. · Tulassay Z.
aSemmelweis University, Second Department of Internal Medicine, and bHungarian Academy of Sciences, Gastroenterological and Endocrinological Research Group, Budapest, Hungary

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Background: Tumor necrosis factor-α (TNF-α) plays a pivotal role in the pathogenesis of inflammatory bowel diseases and bone resorption as well. Limited data exist about the effect of anti-TNF-α infliximab on bone metabolism in inflammatory-type Crohn’s disease (CD). Aim: Our aim was to evaluate the effect of infliximab treatment on rapid changes of bone metabolism in fistulizing CD patients. Methods: 27 patients with fistulizing CD were treated with three series of infliximab. Serum osteocalcin (OC) and β-CrossLaps (bCL) were measured before administration of each infliximab infusion. 54 patients with inactive CD were controls. Results: In treated patients, there were significant differences in bCL concentrations on days 0 and 14 (p < 0.01) and days 0 and 42 (p < 0.05). OC levels increased significantly between day 0 and 42 (p < 0.05). The values of bCL and OC of control groups differed from serum levels in active patients before the treatment, but not on day 42. Bone markers improved significantly in responder patients, but not in non-responders. Conclusion: The beneficial effect of infliximab to the bone metabolism is more expressive in patients whose fistulizing disease improves with this therapy. Our results suggest that TNF-α has an important role in the alteration of bone metabolism in fistulizing CD patients.

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