Anti-tumour necrosis factor alpha treatment in patients affected by rheumatoid arthritis with anti-Ro/SSA antibodies
© BioMed Central Ltd 2005
Received: 11 January 2005
Published: 17 February 2005
To analyse the efficacy and safety of anti-TNF-α treatment in six patients affected by RA with anti-Ro/SSA antibodies and to evaluate the clinical and laboratory changes during the treatment.
Patients and methods
Antinuclear antibodies (IFI on HEp-2 cells), anti-dsDNA (Farr assay), anticardiolipin (aCL, ELISA) and anti-ENA (CIE) were evaluated before the treatment and every 6–12 months. Anti-Ro/SSA antibodies were confirmed by ELISA, using recombinant 52 and 60 kDa Ro proteins (Pharmacia).
Clinical response to anti-tumour necrosis factor alpha treatment in patients with rheumatoid arthritis and anti-Ro/SSA antibodies
Mean Disease Activity Score 44
All the patients were affected by Sjögren syndrome (SS), associated to RA, clinically stable during the treatment. One subject was also affected by primary biliary cirrhosis, which remained clinically and histologically stable. Three patients developed anti-dsDNA at low titre after 6 months and a fourth after 12 months of treatment. Only one patient developed skin lesions after 6 months of Infliximab, clinically and histologically similar to subacute cutaneous lupus with IgM deposits at basal membrane. No patients developed aCL, while the titre of anti-Ro antibodies by ELISA was stable during the treatment. One subject, affected by RA and HCV hepatitis, stopped the etanercept treatment due to severe increase of hepatic enzymes.
Anti-TNF treatment in RA-SS patients with anti-Ro/SSA showed a good and sustained efficacy until the 24th month. Four patients (66.7%) showed anti-dsDNA after 6–12 months, while only one developed subacute cutaneous lupus-like symptoms. No other autoantibodies nor an increase of the anti-Ro titre were observed.
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