Anti-TNF-α Therapy on Bone Mineral Density in Patients with Inflammatory Bowel Disease: An Expanded Cross-sectional Analysis
| Author | Zahra Shokati Eshkiki | en |
| Author | Abolfazl Akbari | en |
| Author | Mahshad Eghbalmanesh | en |
| Author | Elham Pishgar | en |
| Accessioned Date | 2026-07-14T18:33:13Z | |
| Issued Date | 2026-04-30 | en |
| Abstract | Background: Patients with inflammatory bowel disease (IBD) experience a disproportionately high burden of low bone mineral density (BMD) and osteoporosis compared with the general population. Chronic inflammation, nutritional deficiencies, corticosteroid exposure, and changes in body composition all contribute to impaired bone health. Objectives: We aimed to investigate the bone metabolism in cases with anti-tumor necrosis factor-alpha (anti-TNF-α) agents which are widely used to control moderate-to-severe IBD. We examinedd the association between anti-TNF-α therapy and BMD in a cohort of IBD patients receiving care at a tertiary center. Methods: This cross-sectional study enrolled 58 patients with ulcerative colitis or Crohn’s disease were enrolled (29 receiving anti-TNF-α and 29 receiving azathioprine-based therapy). Clinical history, medication exposure, cumulative corticosteroid dose, nutritional supplementation, vitamin D levels, disease activity, and lifestyle factors were recorded. Dual-energy X-ray absorptiometry (DEXA) was used to measure lumbar and femoral BMD. Multivariable logistic regression was performed to identify independent predictors of osteoporosis. Resultss: Overall, 43.1% of participants met criteria for osteoporosis based on Z-scores, with markedly higher prevalence among anti-TNF-α users (65.5% vs. 20.7%, P = 0.01). After adjusting for confounders, anti-TNF-α therapy (OR 3.50; 95% CI 1.20 - 10.20), lower BMD (OR 2.00; 95% CI 1.10 - 3.60), higher cumulative corticosteroid exposure (OR 1.50; 95% CI 1.10 - 2.00), and lower BMI (OR 1.20; 95% CI 1.05 - 1.40) were independently associated with osteoporosis. Conclusions: These findings demonstrate a significant association between anti-TNF-α therapy and lower bone mineral density in patients with inflammatory bowel disease. Given the cross-sectional design, causal relationships cannot be established, and residual confounding by disease severity and treatment indication remains likely. Larger prospective and longitudinal studies are required to clarify the temporal and mechanistic relationships between anti-TNF-α therapy and bone metabolism. | en |
| DOI | https://doi.org/10.5812/semj-168706 | en |
| URI | https://brieflands.com/journals/semj/articles/168706 | en |
| URI | https://repository.brieflands.com/handle/123456789/68015 | |
| Keyword | Inflammatory Bowel Disease | en |
| Keyword | Osteoporosis | en |
| Keyword | Bone Mineral Density | en |
| Keyword | Anti-TNF Therapy | en |
| Keyword | Ulcerative Colitis | en |
| Keyword | Crohn’S Disease | en |
| Publisher | Brieflands | en |
| Title | Anti-TNF-α Therapy on Bone Mineral Density in Patients with Inflammatory Bowel Disease: An Expanded Cross-sectional Analysis | en |
| Type | Research Article | en |
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