Tumour necrosis factor inhibitor-related lupus: safety of switching agents

Clin Rheumatol. 2010 May;29(5):551-3. doi: 10.1007/s10067-009-1365-y. Epub 2010 Feb 2.


An increase in reports of systemic lupus erythematosus (SLE) related to tumour necrosis factor inhibitor (TNFi) therapy has recently been highlighted. We report new-onset SLE in a 22-year-old woman after 13 months of infliximab for ankylosing spondylitis (AS). Lupus symptoms promptly resolved and serologic abnormalities improved after infliximab was ceased. A flare of AS symptoms after 2 months prompted cautious introduction of an alternative TNFi, etanercept. At 14 months follow-up, neither clinical nor serologic flare of lupus had occurred. To our knowledge, this is the third reported case of infliximab-related lupus that did not recur on switching to an alternative TNFi.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / pharmacology*
  • Antirheumatic Agents / pharmacology
  • Autoimmunity
  • DNA / metabolism
  • Etanercept
  • Female
  • Humans
  • Immunoglobulin G / pharmacology*
  • Inflammation
  • Infliximab
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / drug therapy*
  • Quality of Life
  • Receptors, Tumor Necrosis Factor
  • Spondylitis, Ankylosing / blood
  • Spondylitis, Ankylosing / drug therapy*
  • Time Factors
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*


  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha
  • DNA
  • Infliximab
  • Etanercept