Al-Bogami M, Bystrom J, Clanchy F, et al. - This study was undertaken to investigate the impact of TNFα inhibitors on bone density, bone biomarkers, and cytokine production in responder and non-responder patients and evaluated mechanisms of action. Researchers assessed BMD in the lumbar spine and femur neck of 117 RA patients by DEXA scan. They assessed bone turnover biomarkers CTX, osteoprotegerin, osteocalcin and RANKL by ELISA. Multiplex assays and ELISA were applied to evaluate levels of 16 cytokines in plasma and in tissue culture supernatants of ex vivo T cells. This research demonstrates that TNFα inhibitors decrease lumbar spine bone loss in RA patients irrespective of changes in DAS28. In responder patients, the reduction in bone loss is correlated with reduction in IL-20 levels.