Alpha-interferon-induced arthritis: clinical presentation treatment, and prevention.
OBJECTIVE
The therapeutic applications of alpha-interferon (IFN) have expanded greatly to include chronic viral hepatitis and malignant disorders. Autoimmune phenomena occur frequently with IFN therapy, but arthritis is uncommon. We describe the clinical features and treatment of IFN-induced arthritis.


METHODS
A patient with chronic myelogenous leukemia who developed arthritis secondary to IFN therapy is presented. The clinical features and treatment of this condition in 37 additional cases are reviewed.


RESULTS
The most common clinical presentation was symmetric polyarthritis. This was associated with antinuclear antibodies in 72% of patients and rheumatoid factor in 34%. Cessation of IFN, with or without the addition of antiinflammatory or remittive agents, resulted in remission of arthritis in 89% and 71% of the cases, respectively. Restarting IFN therapy resulted in recurrence of arthritis in 63%. In the patient described in this report, recurrence of arthritis was prevented by coadministration of hydroxychloroquine (HCQ) and prednisone.


CONCLUSIONS
Arthritis is an uncommon complication of IFN therapy; but it may lead to cessation of this treatment modality. In such cases, coadministration of a remittive agent such as HCQ may enable reinstitution of IFN therapy without recurrence of arthritis.
Nesher
G
G
Rheumatology Service, Shaare-Zedek Medical Center, Jerusalem, Israel.
Ruchlemer
R
R
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001168:Arthritis / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007213:Indomethacin / Q000627:therapeutic use; D016898:Interferon-alpha / Q000009:adverse effects*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012217:Rheumatoid Factor / Q000097:blood; D055502:Secondary Prevention
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000974:Antibodies, Antinuclear; D000970:Antineoplastic Agents; D018501:Antirheumatic Agents; D016898:Interferon-alpha; D006886:Hydroxychloroquine; D012217:Rheumatoid Factor; D011241:Prednisone; D007213:Indomethacin