We performed a systematic search of databases from 1990 to 2013 to identify articles concerning the new onset of
dermatomyositis/
polymyositis (DM/PM) in patients treated with anti-TNF-α
therapy. We retrieved 13 publications describing 20 patients where the new onset of DM/PM after anti-TNF-α
therapy was recorded. 17 patients were affected by
rheumatoid arthritis (RA), one by
Crohn's disease, one by ankylosing spondilytis, and one by seronegative
arthritis. In 91% of the cases
antinuclear autoantibodies were detected after the introduction of anti-TNF-α
therapy. In 6 patients antisynthetase
antibodies were detected and other clinical findings as
interstitial lung disease (ILD) were recorded. Improvement of DM/PM after anti-TNF
suspension (with the concomitant use of other immunosuppressors) was recorded in 94% of cases. The emergence of DM/PM and
antisynthetase syndrome seem to be associated with the use of anti-TNF-α agents, especially in patients with chronic inflammatory diseases (mainly RA) with positive
autoantibodies before
therapy initiation. In particular, physicians should pay attention to patients affected by RA with positive antisynthetase
antibodies and/or history of ILD. In those cases, the use of the TNF-α blocking agents may trigger the onset of PM/DM or
antisynthetase syndrome or may aggravate/trigger the
lung disease.