RESEARCH - Evolution of ANA and clinical patterns in patients with RA with longterm Remicade therapy

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J Rheumatol. 2006 Jan;33(1):24-30.

Evolution of antinuclear antibodies and clinical patterns in patients with

active rheumatoid arthritis with longterm infliximab therapy.

Comby E, Tanaff P, tte D, Costentin-Pignol V, Marcelli C, Ballet JJ.

From the Laboratoire d'Immunologie et Immunopathologie, UPRES-EA 2128, and

Service de Rhumatologie, CHU, Caen, France.

OBJECTIVE: To investigate the effect of longterm infliximab therapy on serum

levels of fluorescent antinuclear and anti-double and single-stranded DNA

antibodies (FANA, anti-dsDNA, anti-ssDNA) in patients with rheumatoid

arthritis (RA), and their possible association with clinical evolution.

METHODS: Sera from 58 RA patients, treated for one to 3 years with

infliximab, were retrospectively analyzed. Matched control groups were RA

patients treated with corticosteroids or methotrexate. FANA were tested

using HEp-2 cells, and anti-dsDNA and anti-ssDNA IgG by ELISA. After 28

months of infliximab therapy, clinical status was evaluated in 43/58

patients with uninterrupted therapy and associations with autoantibody

levels were investigated. Data were documented for patients who discontinued

infliximab. RESULTS: Over the 3 year period, significant increases in FANA

and anti-ssDNA IgG levels were observed in infliximab treated patients (p <

0.001 and p < 0.01, respectively). In 43 patients with an uninterrupted

infliximab regimen, association was found between high FANA (>/= 1/1280) and

lower age (p = 0.048) and patient's assessment of infliximab's efficacy (p =

0.014). Three patients developed anti-dsDNA IgG, preceded by high anti-ssDNA

IgG levels, and one of them developed a lupus-like syndrome. Neither the

initial presence of high FANA levels nor their increase >/= 1/1280 was

significantly associated with discontinuation of infliximab. In contrast, at

baseline (p = 0.0012) and at the time of infliximab discontinuation (p =

0.0078), anti-ssDNA IgG (>/= 500 arbitrary units) were more frequent in 7

patients who stopped infliximab due to skin or systemic anaphylactoid

reactions.

CONCLUSION: Monitoring of serum FANA, anti-dsDNA, and anti-ssDNA IgG

antibodies provided predictors of lupus-like symptoms and/or anaphylactoid

reactions in patients with RA.

PMID: 16395746

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6395746 & dopt=Abstract

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