Authors: Atzeni, Fabiola; Sarzi-Puttini, Piercarlo

Source: Expert Review of Clinical Immunology, Volume 4, Number 2, March 2008 , pp. 275-280(6)

Publisher: Expert Reviews

Abstract:

Patients with rheumatoid arthritis, Crohns disease or spondyloarthritis who are treated with selective TNF- inhibitors may develop autoantibodies, such as antinuclear antibodies (ANAs) and anti-dsDNA antibodies. Various methods have shown that infliximab led to ANAs in 2976.7% and anti-dsDNA antibodies in 1029% of rheumatoid arthritis patients participating in clinical trials. Furthermore, ANAs and anti-dsDNA antibodies have appeared in 1136 and 515% of rheumatoid arthritis patients treated with etanercept and 12.9% and 5.3% of those treated with adalimumab, respectively. Antiphospholipid antibodies, which are mainly detected by means of anticardiolipin assays, have also been found in rheumatoid arthritis patients receiving TNF- blockers. There have been a number of reports of the development of antidrug antibodies, of which those against infliximab lead to infusion reactions and shorter responses to treatment. This has led some authors to conclude that it is necessary to add methotrexate to infliximab in order to reduce the risk of the appearance of anti-idiotype autoantibodies

Keywords: anti-dsDNA antibody; antinuclear antibody; antiphospholipid antibody; autoantibody; TNF- agent

Document Type: Research article

DOI: http://dx.doi.org/10.1586/1744666X.4.2.275

Affiliations: 1: Rheumatology Unit, University Hospital L Sacco, Via GB Grassi, 74, 20157 Milano, Italy., Email: atzenifabiola@hotmail.com

Publication date: 2008-03-01

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• Expert Review of Clinical Immunology provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in disease states with a strong immunologic component, such as allergic asthma, rheumatoid arthritis, inflammatory bowel disease, psoriasis and multiple sclerosis
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