Evaluation of bone turnover and osteoclastic cytokines in early rheumatoidarthritis treated with alendronate

Objective. Osteoporosis is a frequent complication of rheumatoid arthritis (RA). We investigated the effect of oral alendronate (AL) therapy on bone t urnover and osteoclast activating factors in early RA. Methods. A 90 day randomized placebo controlled trial of 40 mg oral AL/day compared with placebo in 32 patients with early mild disease. Serum interle ukin 1 alpha (IL-1 alpha), tumor necrosis factor-alpha (TNF-alpha). IL-6, b eta(2)microglobulin (beta(2)m), erythrocyte sedimentation rate (ESR), C-rea ctive protein (CRP), osteocalcin/bone gla protein (BGP), urinary crosslinks , and urinary hydroxyproline (HP) measured at 30 and 90 day intervals were the variables measured. Results, A significant decrease of IL-1, IL-6, TNF-alpha, and beta(2)m was observed after 30 days, persisting after 90 days in the AL group, but with no significant variation in the placebo group. A significant decrease of ES R and CRP was observed after 90 days in the AL group, but with no significa nt variation after 30 days in the AL group, and after both 30 and 90 days i n the placebo group. A significant decrease of BGP, WP, and urinary crossli nks was observed after 30 days, persisting after 90 days in the AL group, b ut with no significant variation in the placebo group. Conclusion, Our study demonstrates that alendronate reduces bone turnover i n early RA and may have a possible antiarthritic effect, Because of the mil d early form of the disease in the study cohort, further evaluations are re quired to confirm this effect.