eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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4/2015
vol. 32
 
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abstract:

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

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

Postep Derm Alergol 2015; XXXII (4): 250–254
DOI: https://doi.org/10.5114/pdia.2015.53320
Online publish date: 2015/08/12
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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, psoriasis, psoriatic arthritis, anti-tumor necrosis factor-induced lupus, drug-induced lupus
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