Retrospective Comparison of the Effect of IL-17 Blocker Therapy and Anti-TNF Agent Therapy on Bone Mineral Density in Axial Spondyloartropathy Patients

Abstract

Objective:Our aim was to compare the bone mineral density (BMD) levels in axial spondyloarthropathy (AxSpA) patients treated with tumor necrosis factor-α (TNFα) agents and interleukin-17 (IL-17) blockers.Materials and Methods:This retrospective study was approved by the local ethics committee (07/01/2020, 7). We evaluated the medical records of AxSpA patients treated with either anti-TNFα or IL-17 blocker. Sixty-six patients with two consecutive dual energy X-ray absorptionmetry measurements (baseline and year one) were included. Twenty-seven patients were receiving anti-TNFα and 39 patients were receiving IL-17 blocker treatment. Outcome measures were compared between the IL-17 blocker and anti-TNFα agent treatment groups.Results:Sixty-two percent of the patients were male and 38% were female. The mean lumbar region (L1-L4) BMD value of the patients was 1.19±0.15 gr/cm2 and the mean femoral neck BMD value was 0.95±0.13 gr/cm2 at baseline (p>0.05). A statistically significant increase in BMD values in the lumbar region (L1-L4, L2-L4), femoral neck and femur total was detected at the end of one year observation in patients using both anti-TNF and IL-17 blockers (p<0.05). The rate of increase in femoral total BMD was higher in patients receiving IL-17 blockers than in those receiving anti-TNF (p=0.013).Conclusion:BMD is decreased in AxSpA patients due to inflammation. Our results showed that biological agents in AxSpA increase BMD values in addition to preventing bone loss. Femoral total BMD increase was found to be higher in patients using the IL-17 blocker.

Keywords

• axial spondyloarthropathy
• ankylosing spondylitis
• il-17 blockers
• bone mineral density
• osteoporosis
• tnf inhibitors