Abstract
Background:The anti-TNFatherapy has been since its approval by the FDA, along with nonsteroidal antiinflammatory drugs (NSAIDs), one of the most important therapies for control of spondyloarthritis (SpA). The onset of Lupus Like Syndrome (LLS) has been described in patients with rheumatoid arthritis (RA) treated with anti-TNFatherapy but there is little literature on the occurrence of this entity in patients with SpA.
Methods:We studied 57 patients with SpA who received more than 1 year of anti-TNFatherapy (infliximab, adalimumab or etanercept). Patients were analyzed for the development of LLS, in addition to measuring ANA levels ≥1:160 and Anti-dsDNA (measured by IIF).
Results:In total, 7.01% of patients treated with anti-TNFahad titers of ANA≥1:160, whereas 3.5% of patients had serum levels of dsDNA. However, only one patient (1.75%; n = 1) experienced clinical symptoms of LLS; this was a female patient with a history of psoriatic arthritis.
Conclusions:The presence of LLS secondary to anti-TNFatherapy in patients with SpA is observed less frequently compared with patients with RA. LLS was only detected in a patient with a history of psoriasis since youth, who developed psoriatic arthritis after 27 years of age and had received anti-TNFatherapy for > 2 years. This may be because LLS is an entity clearly associated with innate immunity, with little central role of B and T cells.
Keywords:Antinuclear antibodies, Lupus-like syndrome, Anti-TNFa?α? therapy, Anti-dsDNA, Psoriasis