Maintenance infliximab treatment is associated with improved bone mineral density in Crohn's disease.

Objectives: Diminished bone mineral density (BMD) is a recognized complication of Crohn's disease (CD). The mechanisms underlying bone loss are unclear but may include a direct effect of inflammatory cytokines related to disease activity. Because tumor necrosis factor alpha (TNF-alpha) plays a central role in the pathogenesis of CD inflammation, we evaluated the effect on BMD of maintenance treatment with infliximab in patients with CD.

Methods: BMD of the lumbar spine (L2-L4) and proximal left femur (neck and trochanter) were measured at baseline and 1 yr in 46 CD patients treated with infliximab (5 mg/kg) at 6-8 wk intervals for 1 yr. Thirteen patients received concurrent prednisone at a mean dose of 10 mg/day (range: 5-15).

Results: At baseline, reduced BMD (T-score
Conclusions: Maintenance treatment with infliximab improves BMD in patients with CD and this effect is independent of corticosteroid administration. The BMD response after infliximab suggests that TNF-alpha plays a role in the bone loss associated with CD.