title: Use of anti-tumor necrosis factor biologics in the treatment of rheumatoid arthritis does not change human T-lymphotropic virus type 1 markers: a case series.
abstract: Anti-tumor necrosis factor (anti-TNF) biologics are effective in the treatment of rheumatoid arthritis (RA); however, it is still not clear whether this treatment promotes the development of malignancies such as lymphoma. Human T-lymphotropic virus type 1 (HTLV-1), which is a causative agent of adult T-cell lymphoma (ATL), is prevalent in Japan. Many HTLV-1-positive patients with RA are assumed to exist; however, there have thus far been no reports on the effect of anti-TNF biologics on HTLV-1-positive patients. We analyzed the response to treatment with anti-TNF biologics and change of HTLV-1 markers in two cases of RA. The two cases showed no response based on the European League Against of Rheumatism response criteria 60-96 weeks after administration of anti-TNF biologics (infliximab and etanercept). No signs of ATL were observed and HTLV-1 markers, such as proviral load and clonality of HTLV-1-infected cells, showed no significant change in either of two cases. Therefore, treatment with anti-TNF biologics did not induce activation of HTLV-1, although the effect on RA was not as effective as in HTLV-1-negative patients in this limited study. Further long-term study with a greater number of patients is necessary to clarify the safety and efficacy of anti-TNF biologics in HTLV-1-positive patients with RA.
authors.affiliation: a Division of Rheumatology, Infectious Diseases and Laboratory Medicine, Department of Internal Medicine , Faculty of Medicine, University of Miyazaki , Miyazaki , Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Umekita
authors.forename: Kazumi
authors.initials: K
authors.lastname: Umeki
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyauchi
authors.forename: Shiro
authors.initials: S
authors.lastname: Ueno
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kubo
authors.forename: Norio
authors.initials: N
authors.lastname: Kusumoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takajo
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagatomo
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okayama
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000378:metabolism / Q000821:virology; D001688:Biological Products; D015415:Biomarkers / Q000097:blood; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D015490:HTLV-I Infections / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab / Q000627:therapeutic use*; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000378:metabolism
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D015415:Biomarkers; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept
keywords: Anti-TNF biologics; Human T-lymphotropic virus type 1; Lymphoma; Rheumatoid arthritis; Viral infection