Document Detail


Polyarthritis flare complicating rheumatoid arthritis infliximab therapy: a paradoxic adverse reaction.
MedLine Citation:
PMID:  17149054     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The treatment of rheumatoid arthritis (RA) has changed dramatically over the past decade with the introduction of antitumor necrosis factor (anti-TNF) agents. Although subsets of patients may have only partial or no response, there is no report yet on possible worsening of RA with this therapy. OBJECTIVE: The objective of this study was to determine whether infliximab may paradoxically exacerbate RA. METHODS: One hundred seven patients with RA refractory to 3 disease-modifying antirheumatic drugs were treated with 3 mg/kg infliximab and methotrexate for at least 6 months. RESULTS: In 3 patients, there was an exacerbation of RA associated with the use of infliximab. The flare occurred during the first 6 to 12 months of treatment with polyarthritis, fever, and elevated acute phase reactants. Increase of infliximab dose resulted in further deterioration. CONCLUSION: We describe a paradoxic reaction, an exacerbation of RA, with infliximab. The mechanism of this side effect is unclear but may be related to altered immunity induced by the inhibition of TNF activity in predisposed patients.
Authors:
Michael Rozenbaum; Nina Boulman; Gleb Slobodin; Elena Ayubkhanov; Itzhak Rosner
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases     Volume:  12     ISSN:  1076-1608     ISO Abbreviation:  J Clin Rheumatol     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-06     Completed Date:  2007-02-28     Revised Date:  2008-04-10    
Medline Journal Info:
Nlm Unique ID:  9518034     Medline TA:  J Clin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  269-71     Citation Subset:  IM    
Affiliation:
Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antibodies, Monoclonal / adverse effects*,  therapeutic use*
Arthritis, Rheumatoid / classification,  drug therapy*,  pathology*
Female
Humans
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/infliximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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