Tumour necrosis factor inhibitor-related lupus: safety of switching agents.
An increase in reports of systemic lupus erythematosus (SLE) related to tumour necrosis factor inhibitor (TNFi) therapy has recently been highlighted. We report new-onset SLE in a 22-year-old woman after 13 months of infliximab for ankylosing spondylitis (AS). Lupus symptoms promptly resolved and serologic abnormalities improved after infliximab was ceased. A flare of AS symptoms after 2 months prompted cautious introduction of an alternative TNFi, etanercept. At 14 months follow-up, neither clinical nor serologic flare of lupus had occurred. To our knowledge, this is the third reported case of infliximab-related lupus that did not recur on switching to an alternative TNFi.
Luong
Jessica M T
JM
Department of Rheumatology, Austin Health, PO Box 5555, Heidelberg, VIC, 3084, Australia. jessica.luong@austin.org.au
Tan
Boon T
BT
Buchanan
Russell R C
RR
Schachna
Lionel
L
D000328:Adult; D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D018501:Antirheumatic Agents / Q000494:pharmacology; D015551:Autoimmunity; D004247:DNA / Q000378:metabolism; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000494:pharmacology*; D007249:Inflammation; D000069285:Infliximab; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000188:drug therapy*; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor; D013167:Spondylitis, Ankylosing / Q000097:blood / Q000188:drug therapy*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D004247:DNA; D000069285:Infliximab; D000068800:Etanercept