Antinuclear antibodies associate with loss of response to anti-TNF alpha therapy in psoriasis - a retrospective, observational study. The British journal of dermatology [Br J Dermatol] Journal article | | Title | Antinuclear antibodies associate with loss of response to anti-TNF alpha therapy in psoriasis - a retrospective, observational study. | | Author(s) | Pink AE, Fonia A, Allen MH, Smith CH, Barker JN | | Institution | St John's Institute of Dermatology, Guy's and St Thomas' NHS Trust and The Division of Genetics and Molecular Medicine, King's College London, Great Maze Pond, London, SE1 9RT. | | Source | Br J Dermatol 2009 Oct 26. | | Abstract | Summary Background An increasing number of patients with severe psoriasis are failing to respond to anti-tumour necrosis factor alpha (anti-TNFalpha) therapy (Etanercept, Infliximab and Adalimumab). Objectives We observed that many of these patients developed anti-nuclear antibodies (ANA) and anti-double stranded DNA (anti-dsDNA) antibodies whilst on treatment prompting us to investigate whether their development is associated with anti-TNF treatment failure. Methods All psoriasis patients that had received anti-TNF therapies were identified and their blood results and treatment histories were obtained from electronic patient records and case notes. Results 97 patients had been treated with anti-TNF agents (60 were on their first agent, 22 had been on and stopped 1 agent, 9 had been on and stopped 2 agents and 6 had been on and stopped all three agents). ANA developed in 16.7% of patients on their first treatment, 54.5% of patients who had failed 1 treatment, 77.8% of patients who had failed 2 treatments and 83.3% of patients who had failed all three treatments. Anti-dsDNA antibodies developed in 1.7%, 27.3%, 33.3% and 83.3% of patients from the same respective groups. Significantly, the antibodies developed before treatment had failed with all three agents and their development was not related to the total time that patients had been on anti-TNF therapy. Conclusions This study suggests that the development of ANA and anti-dsDNA antibodies on anti-TNF treatment may act as a marker of forthcoming treatment failure. Large scale prospective studies are required to assess the importance of this observation. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19863499 |
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