Mo1277 Frequency, Risk Factors, and Adverse Sequelae of Bone Loss in Patients With Ostomy for Inflammatory Bowel Diseases

Abstract Objective Vedolizumab (VDZ) has been incriminated in the occurrence of articular manifestations in patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe musculoskeletal manifestations occurring in IBD patients treated by VDZ and to identify risk factors. Methods In this retrospective monocentric study, we included all consecutive patients treated by VDZ for IBD in our hospital. Incident musculoskeletal manifestations occurring during VDZ treatment were analysed and characteristics of patients with and without articular inflammatory manifestations were compared. Results Between 2013 and 2017, 112 patients were treated with VDZ for IBD: ulcerative colitis (n = 59), Crohn’s disease (n = 49) and undetermined colitis (n = 4). Four patients (3.6%) had a history of SpA, whereas 13 (11.6%) had a history of peripheral arthralgia. Some 102 (91.1%) patients had previously received anti-TNF. After a mean (S.d.) follow-up of 11.4 (8.6) months, 32 (28.6%) patients presented 35 musculoskeletal manifestations, of which 18 were mechanical and 17 inflammatory. Among the latter, 11 had axial or peripheral SpA, 5 had early reversible arthralgia and 1 had chondrocalcinosis (n = 1). Among the 11 SpA patients, only 3 (2.6%) had inactive IBD and may be considered as paradoxical SpA. The only factor associated with occurrence of inflammatory manifestations was history of inflammatory articular manifestation [7/16 (43.8%) vs 10/80 (12.5%), P = 0.007]. Conclusion Musculoskeletal manifestations occurred in almost 30% of IBD patients treated with VDZ, but only half of them were inflammatory. Since most of the patients previously received anti-TNF, occurrence of inflammatory articular manifestations might rather be linked to anti-TNF discontinuation than to VDZ itself.

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Environmental Risk Factors for Inflammatory Bowel Diseases: A Review

Digestive Diseases and Sciences ◽

10.1007/s10620-014-3350-9 ◽

2014 ◽

Vol 60 (2) ◽

pp. 290-298 ◽

Cited By ~ 76

Author(s):

Ashwin N. Ananthakrishnan

Keyword(s):

Risk Factors ◽

Environmental Risk ◽

Inflammatory Bowel Diseases ◽

Environmental Risk Factors ◽

Bowel Diseases ◽

Inflammatory Bowel

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Effect of calcium rich milk consumption on bone loss in patients with inflammatory bowel diseases

Zeitschrift für Gastroenterologie ◽

10.1055/s-2004-827134 ◽

2004 ◽

Vol 42 (05) ◽

Author(s):

M Figler ◽

R Rab ◽

A Kisbenedek ◽

Gy Mózsik

Keyword(s):

Bone Loss ◽

Inflammatory Bowel Diseases ◽

Milk Consumption ◽

Bowel Diseases ◽

Inflammatory Bowel

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The effects of dihydroartemisinin on inflammatory bowel disease-related bone loss in a rat model

Experimental Biology and Medicine ◽

10.1177/1535370218769420 ◽

2018 ◽

Vol 243 (8) ◽

pp. 715-724 ◽

Cited By ~ 5

Author(s):

Xingtao Ge ◽

Zhijian Chen ◽

Zhenjie Xu ◽

Fang Lv ◽

Kewei Zhang ◽

...

Keyword(s):

Natural Products ◽

Bone Loss ◽

Disease Activity ◽

Rat Model ◽

Inflammatory Bowel Diseases ◽

Disease Activity Score ◽

Osteoclast Formation ◽

Bowel Diseases ◽

Inflammatory Bowel

Bone loss is one of the important extra-intestinal manifestations in patients with inflammatory bowel diseases (IBDs). Compounds derived from natural products have been used to treat IBDs. However, the role of natural products on IBD-induced bone loss is not completely clarified. In the present study, we observed the effects of dihydroartemisinin (DHA), an antimalaria drug, on IBD and IBD-induced bone loss in a rat model. Chronic IBD model was established in Sprague-Dawley rats by giving them 2.5% dextran sodium sulfate in drinking water. DHA was given by intraperitoneal injection. Blood, colon, and bone samples were collected for biomarker assay and histological analysis. There was an obvious increase in tumor necrotic factor (TNF) α and receptor activator of nuclear factor (NF)-kB ligand (RANKL), and decrease in procollagen type 1 N-terminal propeptide (P1NP) level in IBD groups compared with the normal control (p < 0.05). The disease activity score of IBD rats was significantly higher than the control (p < 0.01). Obvious decrease in disease activity score, TNFα, and RANKL level and increase in P1NP were observed in DHA-treated IBD rats. Bone loss, shown as the decrease in bone mineral density, bone volume fraction, and trabecular number and increase in trabecular separation were observed in IBD rats compared with control (p < 0.01). DHA treatment obviously abolished the bone loss, in particular in the high-dose group (p < 0.05). DHA treatment also inhibited the excessive osteoclast formation; RANKL protein expression; and RANK, TRAF6, Fra-1, NFATc1 mRNA expression induced by IBD. Our data indicated that DHA may be a potential therapeutic agent for IBD and IBD-induced bone loss. Impact statement Bone loss is one of the important extra-intestinal manifestations in patients with inflammatory bowel diseases (IBDs). Studies have shown that compounds derived from natural products are useful in the treatment of IBDs. However, few studies have investigated the role of compounds derived from natural products in treatment of osteoporosis in IBDs. The current study aimed to show the effects of dihydroartemisinin (DHA), antimalaria drug, on bone loss in a rat model of IBD. The findings showed that DHA intervention dose dependently protected against bone loss in IBD rats by inhibiting tumor necrotic factor α production and osteoclast formation. These findings highlights that DHA may be beneficial for bone health in those patients with IBD.

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