Autoantibody profile during short-term infliximab treatment for Crohn's disease: a prospective cohort study.

Abstract

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 0, 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.

• Authors: F Atzeni, S Ardizzone, P Sarzi-Puttini, E Colombo, G Maconi, S De Portu, M Carrabba, G Bianchi Porro
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 22 Issue 5 Pg. 453-61 (Sep 01 2005) ISSN: 0269-2813 [Print] England
• PMID: 16128684 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal
• Autoantibodies
• Gastrointestinal Agents
• Infliximab

Topics

• Adolescent
• Adult
• Aged
• Antibodies, Monoclonal (adverse effects, therapeutic use)
• Autoantibodies (analysis)
• Cohort Studies
• Crohn Disease (drug therapy, immunology)
• Drug Resistance
• Female
• Gastrointestinal Agents (adverse effects, therapeutic use)
• Humans
• Infliximab
• Male
• Middle Aged
• Prospective Studies