Abstract
An increase in reports of systemic lupus erythematosus (SLE) related to tumour necrosis factor inhibitor (TNFi) therapy has recently been highlighted. We report new-onset SLE in a 22-year-old woman after 13 months of infliximab for ankylosing spondylitis (AS). Lupus symptoms promptly resolved and serologic abnormalities improved after infliximab was ceased. A flare of AS symptoms after 2 months prompted cautious introduction of an alternative TNFi, etanercept. At 14 months follow-up, neither clinical nor serologic flare of lupus had occurred. To our knowledge, this is the third reported case of infliximab-related lupus that did not recur on switching to an alternative TNFi.
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References
Drug-induced lupus erythematosus: an emerging association with TNF inhibitors. Australian Adverse Drug Reactions Bulletin 2009;28:10-11
De Bandt M, Sibilia J, Le Loet X et al (2005) Systemic lupus erythematosus induced by anti-tumour necrosis factor alpha therapy: a French national survey. Arthritis Res Ther 7:R545–R551
Ramos-Casals M, Brito-Zeron P, Munoz S et al (2007) Autoimmune diseases induced by TNF-targeted therapies: analysis of 233 cases. Medicine (Baltimore) 86:242–251
Costa MF, Said NR, Zimmermann B (2008) Drug-induced lupus due to anti-tumor necrosis factor alpha agents. Semin Arthritis Rheum 37:381–387
Williams EL, Gadola S, Edwards CJ (2009) Anti-TNF-induced lupus. Rheumatology 48:716–720
Bongartz T, Sutton AJ, Sweeting MJ, Buchan I, Matteson EL, Montori V (2006) Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA 295:2275–2285
Thornhill J, Watson KD, Lord PA, Symmons P, Hyrich KL (2008) Drug-induced lupus in patients with inflammatory arthritis treated with TNF blocking agents: results from the BSR biologics register. Rheumatology 47:ii15
Siegel M, Lee SL, Peress NS (1967) The epidemiology of drug-induced systemic lupus erythematosus. Arthritis Rheum 10:407–415
Matsuura T, Shimizu Y, Fujimoto H, Miyazaki T, Kano S (1992) Minocycline-related lupus. Lancet 340:1553
Kocharla L, Mongey AB (2009) Is the development of drug-related lupus a contraindication for switching from one TNF alpha inhibitor to another? Lupus 18:169–171
Disclosures
Dr. Lionel Schachna has obtained speaker fees for presentations to rheumatologists and general practitioners on ankylosing spondylitis. The Austin Spondylitis Clinic obtains funds from the three TNF inhibitor pharmaceutical companies. Dr. Schachna has also obtained travel assistance to attend the American College of Rheumatology ASM from Abbott.
Dr. Russell Buchanan has given talks to hospital residents and general practitioners in sessions funded by Wyeth and Abbott. He attended three meetings over the last 2 years of the Australian Humira Medical Advisory Board following which Abbott provided funding for attendance to the 2009 Australian Rheumatology Association and 2008 European League Against Rheumatism (EULAR) annual scientific meetings. Wyeth provided funds for an unrestricted education grant for research activities within the Department of Rheumatology, Austin Health.
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Luong, J.M.T., Tan, B.T., Buchanan, R.R.C. et al. Tumour necrosis factor inhibitor-related lupus: safety of switching agents. Clin Rheumatol 29, 551–553 (2010). https://doi.org/10.1007/s10067-009-1365-y
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DOI: https://doi.org/10.1007/s10067-009-1365-y