Background: The potential clinical implications of autoimmunity during treatment with infliximab are unclear. Aim: To determine the frequency and correlation of autoantibody formation in patients with Crohn's disease treated with infliximab in a routine clinical setting. Methods: Sixty-three patients with refractory/inflammatory (31) and/or fistulising Crohn's disease (32), received an infliximab infusion at a dose 5 mg/kg in weeks O, 2 and 6, and were evaluated for the development of antinuclear, anti-double-stranded DNA, anti-Sm, anti-RNP, anti-SSA, anti-SSB and antihistone antibodies. The correlates with pharmacological treatments, the response to infliximab and adverse events were evaluated. Results: Antinuclear antibodies were found in five of the 63 patients (8%) at baseline and in 26 (42%) after 10 weeks (P < 0.001). Of the 26 antinuclear antibody-positive patients who were further subtyped, nine of 63 (17%) had anti-double-stranded DNA (P = 0.003), and 1.5% were extractable nuclear antigen (ENA) and antihistone-positive. Five patients were initially positive for anticardiolipin antibodies and two more patients became positive during infliximab treatment. New autoantibody formation was more frequent in the patients with inflammatory/refractory disease than in those with fistulising disease (17 vs. 7; P = 0.02). One patient developed drug-induced lupus without major organ damage. Conclusions: Autoantibody formation occurs in 42% of patients (8% of these patients were positive before infliximab treatment) with Crohn's disease receiving induction treatment with infliximab, but the clinical significance of this remains to be determined. (copyright) 2005 Blackwell Publishing Ltd.
|Titolo:||Autoantibody profile during short-term infliximab treatment for Crohn's disease : a prospective cohort study|
|Parole Chiave:||Crohn disease; abdominal abscess; adolescent; adult; aged; antibody production; antibody titer; arthralgia; article; autoimmune disease; autoimmunity; cohort analysis; controlled study; demography; drug response; drug safety; female; human; injection site reaction; intestine obstruction; liver abscess; lupus erythematosus; major clinical study; male; pneumonia; priority journal; DNA antibody; La antibody; Ro antibody; Sm antibody; amoxicillin plus clavulanic acid; antinuclear antibody; autoantibody; cardiolipin antibody; double stranded DNA; histone antibody; infliximab; ribonucleoprotein antibody; remicade|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||2005|
|Digital Object Identifier (DOI):||10.1111/j.1365-2036.2005.02576.x|
|Appare nelle tipologie:||01 - Articolo su periodico|