ANTINUCLEAR ANTIBODIES (ANA) IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH INFLIXIMAB

G. Bonilla , F. Gamero , J. Fernandez-Melón , R. Alvarez-Doformo , A. Balsa , E. Martín-Mola Rheumatology Unit, Inmunology Unit, La Paz University Hospital, Madrid, SpainObjectives: To examine the evolution of ANA in patients with rheumatoid arthritis treated con infliximab (anti- TNF- alpha).Methods: 40 patients with active rheumatoid arthritis (31 woman and 9 men) who presented severe evolution with no response to classical disease modifying anti-rheumatic drugs (DMARDS) were treated with infliximab 3mg/kg and methotrexate or leflunomide (29/9). Two patients were treated with infliximab, methrotrexate and leflunomide. These patients ranged in age from 23 to 75 (mean of 53,95 ± 13,02 years). Clinical evaluatios at baseline (week 0) and before each infusion (weeks 2,6,14 and 22) included medical history, phisical examination, swollen and painful joint count, VAS for pain, VAS as a global assessment by patient and physician, Health Assesment Questionaire (HAQ), complete blood account, urine analyses, liver and renal function, ESR,CRP, ANA, ds-DNA and DAS28.Results: At baseline 11 patients (27,5%) were ANA positive,two of them 1/40, two 1/80, one 1/160, two 1/320, three 1/640 and one 1/1280. At week 22, 22 patients (55%) were ANA positive. 11 patients (27,5%) who at baseline were ANA negative showed ANA positive on week 22. One of them 1/40, one 1/80, one 1/160, three 1/320, four 1/640 and other one 1/1280. Four (10%) of the patients who were ANA positive at baseline had increased title on week 22: one from 1/40 to 1/80, one from 1/40 to 1/160, one from 1/160 to 1/640 and one 1/1280 to 1/5120. After the fourth infusion of infliximab all patients with ANA positive were dsDNA negative.Conclusion: In our experience, treatment with infliximab produce an increase of the title of ANA in four patients (10%). And 11 patients (27,5%) with previos negative test for ANA changed to positive after the fourth infusion. All cases were negative for dsDNA and no sintoms of lupus were seen.Citation: , volume , supplement , year 2003, page Session: Rheumatoid arthritis – Treatment