The aim of the study was to evaluate a panel of
autoantibodies in patients affected by
rheumatoid arthritis (RA) treated with anti-
TNFalpha blockers, and to consider a different
autoantibody induction effect by
infliximab and
etanercept; and in addition to evaluate in these cases a relationship between
antinuclear antibody (ANA) titre and both
C-reactive protein (CRP) and Blys levels. Fifty-four patients (8 men, 46 women, mean age 51.4 years, mean duration of disease 13.6 years) affected by refractory RA were treated with anti-
TNFalpha blockers for 12 consecutive months; 43 patients were given
infliximab and 11
etanercept. At baseline and every 4 months a panel of
autoantibodies consisting of
rheumatoid factor, antinuclear, anti-
double-stranded DNA, anti-ENA, anti-mitochondrial, anti-thyroid and
anti-neutrophil cytoplasmic antibodies (
ANCA) was tested. At the same time CRP level was measured. Blys level was determined at baseline and after 1 year in five cases that developed a strong positivity for ANA during
infliximab therapy. In 41 cases (95.3%) treated with
infliximab, ANA were detected on at least one occasion, and in almost half of these cases the titre was very high, equal to or higher than 1:1.280. On the other hand, patients treated with
etanercept presented ANA positivity in a lower percentage of cases and at a low titre. No correlation was found between ANA titre and CRP level; Blys level did not present a constant trend in patients who developed a very high positivity for ANA. Anti-
double-stranded DNA, anti-thyroid or
ANCA were found only in a few patients, in the absence of a clinical picture indicative of
systemic lupus erythematosus,
autoimmune thyroiditis or
ANCA-associated vasculitis. A different incidence of ANA positivity was found in
infliximab- and
etanercept-treated RA patients; this finding might be due to the partially different method of inhibition of
TNFalpha between the two drugs. Both CRP and Blys do not seem to participate in this phenomenon. Other
autoantibodies were detected in a few patients, but no case of onset of new autoimmune disorders was observed.