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Induction of ANA, anti-dsDNA and anti-nucleosome antibodies following infliximab treatment in rheumatoid arthritis and spondyloarthropathy patients

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Background

Rheumatoid arthritis (RA) and spondyloarthropathy (SpA) patients are successfully treated with infliximab. There is indication that this therapy induces ANA and anti-dsDNA antibodies in RA.

Objectives

To investigate the induction of ANA, anti-dsDNA and anti-nucleosome antibodies in both RA and SpA after infliximab treatment.

Patients and methods

Sera from 62 patients with refractory RA treated with infliximab (3 mg/kg infliximab IV at week 0, 2, 6 and every 8 weeks thereafter) were obtained at baseline and week 30. Sera from 35 patients with active SpA treated with infliximab (5 mg/kg infliximab IV at week 0, 2 and 6 and 10 mg/kg every 14 weeks thereafter) were obtained at baseline and week 34. Samples were tested for ANA (indirect immunofluorecence [IIF] on HEp-2 cells), anti-dsDNA antibodies (IIF on Crithidia luciliae and Varelisa, PharmaciaDiagnostics), anti-nucleosome antibodies (Medizym anti-Nucleo, Medipan Diagnostica).

Results

At baseline, 32/62 RA and 6/35 SpA patients were positive for ANA. After infliximab treatment, an increase in ANA intensity of 2 or more steps (on a 0 to 5+ scale) was observed in 28/62 RA and in 26/35 SpA patients. A patient was defined as having developed anti-dsDNA antibodies when a positive result in both the IIF on Crithidia luciliae and anti-dsDNA ELISA was observed. At baseline, none of the RA and SpA patients had anti-dsDNA antibodies. After treatment, 7/62 RA and 6/35 SpA patients developed anti-dsDNA antibodies. At baseline, anti-nucleosome antibodies were observed in 1/62 RA and 3/35 SpA patients. After treatment, 5/62 RA and 4/35 SpA patients were positive for anti-nucleosome antibodies.

Conclusion

Infliximab treatment induced ANA and anti-dsDNA antibodies in both RA and SpA patients. After treatment, anti-dsDNA antibodies were significantly associated with anti-nucleosome antibodies.

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Keywords

  • Public Health
  • Rheumatoid Arthritis
  • Arthritis
  • Positive Result
  • Infliximab