Autoimmune diseases induced by TNF-targeted therapies.
Anti-TNF agents are increasingly being used for a rapidly expanding number of rheumatic and systemic autoimmune diseases. As a result of this use, and of the longer follow-up periods of treatment, there are a growing number of reports of the development of autoimmune processes related to anti-TNF agents. The clinical characteristics, outcomes, and patterns of association with the different anti-TNF agents used in all reports of autoimmune diseases developing after TNF-targeted therapy, were analyzed through a baseline Medline search of articles published between January 1990 and May 2008 (www.biogeas.org). A total of 379 cases of autoimmune diseases secondary to TNF-targeted therapies were identified. The anti-TNF agents were administered for rheumatoid arthritis in more than 80% of cases. The use of anti-TNF agents has been associated with an increasing number of cases of autoimmune diseases, principally cutaneous vasculitis, lupus-like syndrome, systemic lupus erythematosus and interstitial lung disease. Other autoimmune diseases associated with TNF-targeted therapies have been recently described, e.g. sarcoidosis, antiphospholipid syndrome-related features, and autoimmune hepatitis or uveitis. Large, prospective, postmarketing studies are required to evaluate the risk of developing autoimmune diseases in patients receiving TNF-targeted therapies.
Ramos-Casals
Manuel
M
Laboratory of Autoimmune Diseases Josep Font, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain. mramos@clinic.ub.es
Brito-Zerón
Pilar
P
Soto
Maria-Jose
MJ
Cuadrado
Maria-Jose
MJ
Khamashta
Munther A
MA
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced; D016239:MEDLINE; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha