Uso do infliximabe e aparecimento sequencial de autoanticorpos e neoplasia em paciente com espondiloartrite

Golmia, Ricardo Prado; Scheinberg, Morton

doi:10.1590/s0482-50042010000600011

Rev. Bras. Reumatol.

2010

DOI: 10.1590/s0482-50042010000600011

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Uso do infliximabe e aparecimento sequencial de autoanticorpos e neoplasia em paciente com espondiloartrite

Ricardo Prado Golmia¹,

Morton Scheinberg²

Abstract: The development of antinuclear antibodies after long-term use of anti-TNF therapy has been reported by several authors. The occurrence of lymphoproliferative neoplasms and, less commonly, solid tumors has also been reported. We present a case ofsimultaneous development of antinuclear antibodies and solid tumor in a patient with spondyloarthritis while on infliximab therapy. The implications and possible correlations with a solid tumor occurrence are reviewed and discussed.

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Cited by 2 publications

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The clinical importance of the thyroid nodules during anti-tumor necrosis factor therapy in patients with axial spondyloarthritis

et al. 2017

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The clinical importance of the thyroid nodules in patients with axial spondyloarthritis (ax-SpA) rests with the need to exclude thyroid malignancy. The aim of this study is to assess the risk of thyroid malignancy in ax-SpA patients receiving anti-TNF therapy. From September 2015 until December 2015, 70 patients diagnosed with ax-SpA were included in the research. Forty of the patients had received anti-TNF therapy, and 30 of the patients were anti-TNF naive. All cases were screened for the presence of nodules in the thyroid gland with ultrasound. Of the patients that received anti-TNF therapy, 15 (37.5%); and of the anti-TNF naive patients, 11 (36.7%) had thyroid nodule(s). Four patients from the anti-TNF group underwent fine needle aspiration biopsy of the nodules, and two of them were diagnosed with papillary thyroid carcinoma. None of the nodules in anti-TNF naive patients required biopsy. When compared to the normal population, the standardized incidence ratio (SIR) was found to be increased in both male (SIR 2.03, 95% CI 1.9 to 18) and female (SIR 2.7, 95% CI 2.6 to 24) cases. It is not yet established whether the development of cancer during the treatment process is the effect of the treatment or if it is a part of the natural course of the disease or if it is coincidental. We saw a mild increase in thyroid malignancies in ax-SpA patients who received anti-TNF therapy. Therefore, we believe that the thyroid gland should also be taken into consideration while screening for malignancy before anti-TNF therapy.

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The clinical importance of the thyroid nodules during anti-tumor necrosis factor therapy in patients with axial spondyloarthritis

et al. 2017

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Possible Association of Etanercept, Venous Thrombosis, and Induction of Antiphospholipid Syndrome

Virupannavar

Brandau

Guggenheim

et al. 2014

Case Reports in Rheumatology

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Tumor necrosis factor α (TNF α) inhibitors are commonly used for treatment of aggressive rheumatoid arthritis and other rheumatic diseases. Etanercept is one of the medications approved for treatment of rheumatoid arthritis. Though many studies have documented the safety and efficacy of these medications, evidence for adverse effects is emerging including cancer, infections, and cardiovascular disease. There have been studies showing that these medications induce autoantibody production, including antinuclear antibodies and anti-dsDNA antibodies. Limited data exists, however, regarding induction of antiphospholipid antibodies (APLs) by TNF α inhibitors, including anticardiolipin antibodies (ACLs), lupus anticoagulant (LAC), and anti-β 2-glycoprotein I (anti-β 2 GPI), or an association between antibody development and clinical manifestations. In this case series, we describe five patients who developed venous thromboembolism (VTE) and APLs while receiving etanercept therapy. All five of our patients met the criteria for diagnosis of APS after receiving etanercept. Our case series supports the association between etanercept, APLs, and VTE. We believe that testing for APLs prior to initiation of anti-TNF therapy is reasonable, given this relationship and the risks associated with VTE.

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Uso do infliximabe e aparecimento sequencial de autoanticorpos e neoplasia em paciente com espondiloartrite

Cited by 2 publications

References 12 publications

The clinical importance of the thyroid nodules during anti-tumor necrosis factor therapy in patients with axial spondyloarthritis

The clinical importance of the thyroid nodules during anti-tumor necrosis factor therapy in patients with axial spondyloarthritis

Possible Association of Etanercept, Venous Thrombosis, and Induction of Antiphospholipid Syndrome

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