Limits...
Antiphospholipid antibodies during 6-month treatment with infliximab: a preliminary report.

Kolarz B, Majdan M, Darmochwal-Kolarz DA, Dryglewska M - Med. Sci. Monit. (2014)

Bottom Line: There are contradictory results concerning the ability of infliximab to induce aPL, but most authors confirm this phenomenon.The role of aPL in pathogenesis of APS is still unclear, but we should remember the immunogenic aspect of TNF antagonist treatment.Therefore, we recommend early detection of aPL and observation of the patient, paying special attention to signs and symptoms of thromboembolism.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Immunology, Medical University of Lublin, Lublin, Poland.

ABSTRACT

Background: The introduction of tumor necrosis factor (TNF) antagonists (adalimumab, infliximab, and etanercept) was a major advance and was highly important and beneficial in most rheumatoid arthritis (RA) patients. The adverse effects of this treatment are infrequent, but include opportunistic intracellular infection (especially the reactivation of latent Mycobacterium tuberculosis); exacerbation of demyelinating disorders; and the production of various types of antibodies such as antinuclear antibodies (ANA) or double-stranded DNA autoantibodies (dsDNA) and antiphospholipid antibodies (aPL) such as anti-cardiolipin antibodies (aCL) and anti-B2GP-I antibodies (B2GP-I). The aim of the study was to determine the prevalence of aCL and B2GP-I in IgM and IgG classes, using ELISA tests, during 6 months of follow-up in patients with refractory RA successfully treated with infliximab.

Material/methods: We determined the prevalence of aCL and B2GP-I in IgM and IgG classes, using ELISA tests, during 6 months of follow-up in patients with refractory RA successfully treated with infliximab.

Results: We observed a statistically important increase only in the group of B2GP-I IgM (p<0.05). There are contradictory results concerning the ability of infliximab to induce aPL, but most authors confirm this phenomenon.

Conclusions: Further investigations are needed to determine if the new aPL appears in patients with β2-GPI gene polymorphisms such as leucine-to-valine substitution at position 247, which can lead to a conformational changes in β2-GPI protein, leading to aPL synthesis. The role of aPL in pathogenesis of APS is still unclear, but we should remember the immunogenic aspect of TNF antagonist treatment. Therefore, we recommend early detection of aPL and observation of the patient, paying special attention to signs and symptoms of thromboembolism.

Show MeSH

Related in: MedlinePlus

The percentage of aCL and B2GP-I in IgM and IgG classes at the beginning and after 3 and 6 months of rheumatoid arthritis treatment with infliximab.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4109570&req=5

f1-medscimonit-20-1227: The percentage of aCL and B2GP-I in IgM and IgG classes at the beginning and after 3 and 6 months of rheumatoid arthritis treatment with infliximab.

Mentions: We observed 4 aCL IgM-positive (12.5%) patients before the beginning of infliximab treatment. In these cases, we found no changes after 3 and 6 months of observation. There were no aCL IgG-positive patients at the beginning and after 3 months, but 1 case (3.12%) of seroconversion was observed after 6 months in aCL IgG class. During the whole study, we did not observe any B2GP-I IgG-positive patients. Otherwise, we noticed a statistically important increase in the group of B2GP-I IgM-positive patients (p<0.05) (Figure 1). There were 2 (6.25%) seropositive patients before the start of the treatment, 1 (3.33%) after 3 months, and the next 3 (10.3%) after 6 months. Totally, we observed 4 (13.3%) new B2GP-I IgM-positive patients, which was statistically significant.


Antiphospholipid antibodies during 6-month treatment with infliximab: a preliminary report.

Kolarz B, Majdan M, Darmochwal-Kolarz DA, Dryglewska M - Med. Sci. Monit. (2014)

The percentage of aCL and B2GP-I in IgM and IgG classes at the beginning and after 3 and 6 months of rheumatoid arthritis treatment with infliximab.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4109570&req=5

f1-medscimonit-20-1227: The percentage of aCL and B2GP-I in IgM and IgG classes at the beginning and after 3 and 6 months of rheumatoid arthritis treatment with infliximab.
Mentions: We observed 4 aCL IgM-positive (12.5%) patients before the beginning of infliximab treatment. In these cases, we found no changes after 3 and 6 months of observation. There were no aCL IgG-positive patients at the beginning and after 3 months, but 1 case (3.12%) of seroconversion was observed after 6 months in aCL IgG class. During the whole study, we did not observe any B2GP-I IgG-positive patients. Otherwise, we noticed a statistically important increase in the group of B2GP-I IgM-positive patients (p<0.05) (Figure 1). There were 2 (6.25%) seropositive patients before the start of the treatment, 1 (3.33%) after 3 months, and the next 3 (10.3%) after 6 months. Totally, we observed 4 (13.3%) new B2GP-I IgM-positive patients, which was statistically significant.

Bottom Line: There are contradictory results concerning the ability of infliximab to induce aPL, but most authors confirm this phenomenon.The role of aPL in pathogenesis of APS is still unclear, but we should remember the immunogenic aspect of TNF antagonist treatment.Therefore, we recommend early detection of aPL and observation of the patient, paying special attention to signs and symptoms of thromboembolism.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Immunology, Medical University of Lublin, Lublin, Poland.

ABSTRACT

Background: The introduction of tumor necrosis factor (TNF) antagonists (adalimumab, infliximab, and etanercept) was a major advance and was highly important and beneficial in most rheumatoid arthritis (RA) patients. The adverse effects of this treatment are infrequent, but include opportunistic intracellular infection (especially the reactivation of latent Mycobacterium tuberculosis); exacerbation of demyelinating disorders; and the production of various types of antibodies such as antinuclear antibodies (ANA) or double-stranded DNA autoantibodies (dsDNA) and antiphospholipid antibodies (aPL) such as anti-cardiolipin antibodies (aCL) and anti-B2GP-I antibodies (B2GP-I). The aim of the study was to determine the prevalence of aCL and B2GP-I in IgM and IgG classes, using ELISA tests, during 6 months of follow-up in patients with refractory RA successfully treated with infliximab.

Material/methods: We determined the prevalence of aCL and B2GP-I in IgM and IgG classes, using ELISA tests, during 6 months of follow-up in patients with refractory RA successfully treated with infliximab.

Results: We observed a statistically important increase only in the group of B2GP-I IgM (p<0.05). There are contradictory results concerning the ability of infliximab to induce aPL, but most authors confirm this phenomenon.

Conclusions: Further investigations are needed to determine if the new aPL appears in patients with β2-GPI gene polymorphisms such as leucine-to-valine substitution at position 247, which can lead to a conformational changes in β2-GPI protein, leading to aPL synthesis. The role of aPL in pathogenesis of APS is still unclear, but we should remember the immunogenic aspect of TNF antagonist treatment. Therefore, we recommend early detection of aPL and observation of the patient, paying special attention to signs and symptoms of thromboembolism.

Show MeSH
Related in: MedlinePlus