Anti-tnf induced autoimmunity

Aim and Hypothesis: Anti-TNF therapy has recently emerged as an effective therapy for treating rheumatic diseases. With this increasing use and longer follow-up periods of treatment, various adverse effects are emerging. These adverse effects also include autoimmune processes. The aim of this study was to determine the autoimmune processes after anti-TNF therapy for rheumatic diseases. Methods: This study included 67 patients who were treated with anti-TNF drugs for rheumatoid arthritis and ankylosing spondylitis. Thirty-two patients with rheumatoid arthritis and thirty-five patients with ankylosing spondylitis were monitered. Thirty-five patients receiving infliximab, sixteen patients receiving adalimumab, sixteen patients receiving etanercept. According to the rheumatic diseases groups and anti-TNF therapies groups, the patients were divided into subgroups. The ANA and anti-dsDNA antibody levels were identified by the immunefluorescence method and ACA antibody levels were identified by the ELISA methods. Results: In this study, the percentages of ANA positivity in sixty-seven patients range from %10,4 to % 40,3. Whereas only one patient had serum level of anti-dsDNA, no patient had serum level of ACA. ANA induction was more important under infliximab than with the two other anti-TNF blockers. No patiens developed clinical symptoms of lupus who had been seroconversion of antibody. ANA was not influenced by the underlying rheumatism or anti-TNF combined therapies with methotrexate and corticosteroids. Conclusion: Anti-TNF induced autoantibodies are common following therapy with all of the currently available anti-TNF therapies. However the incidence of anti-TNF inducel lupus is rare.