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. 2015 Aug;32(4):250-4.
doi: 10.5114/pdia.2015.53320. Epub 2015 Aug 12.

Autoimmunogenicity during anti-TNF therapy in patients with psoriasis and psoriatic arthritis

Magdalena M Pirowska  1 , Anna Goździalska  2 , Sylwia Lipko-Godlewska  1 , Aleksander Obtułowicz  1 , Joanna Sułowicz  1 , Katarzyna Podolec  1 , Anna Wojas-Pelc  1
Affiliations

Autoimmunogenicity during anti-TNF therapy in patients with psoriasis and psoriatic arthritis

Magdalena M Pirowska et al. Postepy Dermatol Alergol. 2015 Aug.

Abstract

Introduction: The tumor necrosis factor (TNF-α) was initially described as lymphotoxin or cachectin. The discovery of therapies blocking the action of TNF-α, in 1988, started a new era in the therapy. One of often reported adverse effects related to the use of TNF-α antagonists is induction of the formation of autologous antibodies and antibodies neutralizing anti-TNF drugs. The development of anti-TNF-induced lupus or classical drug-induced lupus is more rarely reported.

Aim: To evaluate the presence and the level of anti-nuclear antibodies in patients with psoriasis and psoriatic arthritis and the influence of anti-TNF therapy used on the concentration of antinuclear antibody (ANA).

Material and methods: A total of 28 subjects were included in the study. 71.4% of subjects were diagnosed with psoriatic arthritis and 28.6% with plaque psoriasis.

Results: Among the patients with plaque psoriasis, the antinuclear antibodies were found in 25% of subjects and in 80% of patients with psoriatic arthritis. After the treatment an increase in the titer or appearance of antibodies was found in 66.7% in the infliximab group, 18.2% in the etanercept group and 54.7% in the adalimumab group. No subjects developed symptoms of drug-induced systemic lupus.

Conclusions: Our findings have shown that all anti-TNF therapies induced ANA in psoriatic arthritis and psoriatic patients. Considering a mild course of lupus induced by anti-TNF treatment and, usually intrinsic, resolution of symptoms, the biological therapy still appears as a safe treatment for patients.

Keywords: anti-tumor necrosis factor therapy; anti-tumor necrosis factor-induced lupus; drug-induced lupus; psoriasis; psoriatic arthritis.

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Figures

Figure 1
Figure 1
Antinuclear antibodies among the patients with psoriasis and psoriatic arthritis before anti-TNF treatment
Figure 2
Figure 2
Antinuclear antibodies in the group of patients treated with infliximab
Figure 3
Figure 3
Antinuclear antibodies in the group of patients treated with etanercept
Figure 4
Figure 4
Antinuclear antibodies in the group of patients treated with adalimumab
See this image and copyright information in PMC

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