Tumor Necrosis Factor Alpha Antagonists and Occurrence of Autoantibodies in Inflammatory Bowel Disease Patients: A Single Center Experience

Background & Aims: Appearance of auto antibodies have been described during anti-tumor necrosis factor (TNF) alpha therapy; however, their prevalence and clinical relevance are still unclear. We investigated prevalence of autoantibodies in inflammatory bowel diseases (IBD) patients on anti-TNFα treatment and occurrence of clinical symptoms. Methods: Titers of ANA, anti-dsDNA, SMA, AMA, LKM were evaluated from blood samples in patients receiving anti-TNFα inhibitor (adalimumab, infliximab). Results: Among 39 patients treated with anti-TNFα therapy, twenty of them developed ANA, mostly induced by infliximab. 55% ANA positive patients developed peripheral polyarthralgias with no need for intervention. No patients with positive autoantibodies developed a drug-induced lupus. The incidence of dsDNA, SMA and AMA was low and was not associated with autoimmune disease. Conclusions: Immune response induced by anti-TNFα is restricted to ANA, with lower prevalence of dsDNA antibodies, SMA and AMA. Further studies are needed to clarify the role of autoantibodies during anti-TNFα therapy.