REVIEW - Autoantibody production in patients treated with anti-TNF-alpha

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Expert Rev Clin Immunol. 2008 Mar;4(2):275-80.

Autoantibody production in patients treated with anti-TNF-alpha.

Atzeni F, Sarzi-Puttini P.

Rheumatology Unit, University Hospital L Sacco, Via GB Grassi, 74,

20157 Milano, Italy.

Abstract

Patients with rheumatoid arthritis, Crohn's disease or

spondyloarthritis who are treated with selective TNF-alpha inhibitors

may develop autoantibodies, such as antinuclear antibodies (ANAs) and

anti-dsDNA antibodies. Various methods have shown that infliximab led

to ANAs in 29-76.7% and anti-dsDNA antibodies in 10-29% of rheumatoid

arthritis patients participating in clinical trials. Furthermore, ANAs

and anti-dsDNA antibodies have appeared in 11-36 and 5-15% 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-alpha 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.

PMID: 20477056

http://www.ncbi.nlm.nih.gov/pubmed/20477056

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