Increased prevalence of allergic sensitisation in rheumatoid arthritis patients treated with anti-TNFalpha.
BACKGROUND
Tumour necrosis factor alpha (TNFalpha) has emerged as a therapeutic target in chronic inflammatory disorders characterised by a Th1 type immune response, such as rheumatoid arthritis (RA). The presence of allergic disease in these patients could be influenced both by the presence of RA and anti-TNFalpha therapy. Our aim was to evaluate the prevalence of sensitisation to airborne allergens and allergic disease in RA patients, with and without anti-TNFalpha treatment.


METHODS
RA patients with (N=20) and without (N=20) anti-TNFalpha therapy (groups T and R) were enrolled. Healthy controls (N=60, group C) were randomly selected from the general population. All participants answered a standardised questionnaire to assess the prevalence of allergic disease and had skin prick tests (SPT) with a standard panel of airborne allergen extracts.


RESULTS
Significant differences were found in the prevalence of positive SPT between groups T and R (70% vs 35%, p=0.027) and groups T and C (70% vs 36.7%, p=0.009), but not between groups R and C. The prevalence of allergic disease was similar in the three groups. Groups T and R had similar gender and age distribution, disease duration, disease activity score (DAS28), erythrocyte sedimentation rate and serum C-reactive protein.


CONCLUSIONS
Increased prevalence of sensitisation to airborne allergens in RA patients treated with anti-TNFalpha was found. The clinical impact of the positive SPT following anti-TNFalpha initiation has now to be assessed.
Machado
Pedro
P
Rheumatology Department, Coimbra University Hospital, Praceta Mota Pinto, 3000-075 Coimbra, Portugal. pedrommcmachado@gmail.com
Santos
Alexandra
A
Pereira
Celso
C
Loureiro
Carlos
C
Silva
Jorge
J
Chieira
Celso
C
Malcata
Armando
A
D000068879:Adalimumab; D000328:Adult; D000818:Animals; D000906:Antibodies / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012882:Skin Tests; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000906:Antibodies; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000068879:Adalimumab