Autoantibodies in psoriasis as predictors for loss of response and anti-infliximab antibody induction

Br J Dermatol. 2011 Dec;165(6):1355-8. doi: 10.1111/j.1365-2133.2011.10555.x. Epub 2011 Nov 17.


Background: Infliximab is successfully used to treat psoriasis and psoriatic arthritis. However, some patients lose therapeutic response after several cycles. Antibodies to infliximab (infliximab-Abs) are induced during treatment in a subgroup of patients and are thought to be associated with loss of response (LOR). Routine screening for infliximab-Abs is expensive and not regularly performed. A reliable and affordable method for identifying patients who are at risk for LOR to infliximab is desirable.

Objectives: To analyse the development of antinuclear antibodies (ANA)/antidouble-stranded DNA antibodies (anti-dsDNA) over time in patients with psoriasis receiving infliximab. To analyse if there is an association between ANA titres/anti-dsDNA concentrations, infliximab-Ab status and LOR.

Methods: A retrospective data analysis of 29 patients with psoriasis receiving infliximab was carried out. ANA titres and anti-dsDNA concentrations were regularly monitored in these patients and sera were tested for infliximab-Abs by enzyme-linked immunosorbent assay.

Results: Median ANA titres increased from 1 : 80 [interquartile range (IQR) 0 to 1 : 320, n = 29] pretreatment, to 1 : 1280 (IQR 1 : 640 to 1 : 1920, n = 15) after infusion 10, and 1 : 1920 (IQR 1 : 1280 to 1 : 2560, n = 10) after infusion 20. Infliximab-Abs were found in 21% of patients. Infliximab-Ab-positive patients and patients with LOR had significantly higher pretreatment anti-dsDNA concentrations and higher pretreatment ANA titres than infliximab-Ab-negative and responsive patients, respectively.

Conclusions: The results of this study suggest a role for autoantibodies in the identification of patients with psoriasis at higher risk of developing infliximab-Abs and of LOR under treatment with infliximab.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antinuclear / metabolism*
  • Antibodies, Monoclonal / immunology*
  • Antibodies, Monoclonal / therapeutic use
  • Autoantibodies / metabolism*
  • Case-Control Studies
  • DNA / immunology
  • Dermatologic Agents / immunology*
  • Dermatologic Agents / therapeutic use
  • Drug Resistance / immunology*
  • Female
  • Humans
  • Infliximab
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Psoriasis / drug therapy
  • Psoriasis / immunology*
  • Retrospective Studies


  • Antibodies, Antinuclear
  • Antibodies, Monoclonal
  • Autoantibodies
  • Dermatologic Agents
  • DNA
  • Infliximab