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Arthritis Research and Therapy

, 8:R131

First Online: 26 July 2006Received: 27 April 2006Revised: 10 July 2006Accepted: 26 July 2006


In the present study we evaluated the impact of baseline antinuclear antibody ANA status and use of methotrexate on development of infliximab-related infusion reactions in patients with rheumatoid arthritis RA or spondylarthropathies SpAs, including psoriatic arthritis. All patients with RA n = 213 or SpA n = 76 treated with infliximab during the period 1999–2005 at the Department of Rheumatology in Lund, Sweden were included. ANAs were present in 28% and 25% of RA and SpA patients, respectively. Because of differences in baseline characteristics, we used a binary logistic regression model to calculate odds ratios ORs, adjusting for age, sex and prednisolone dosage. Altogether 21% of patients with RA and 13% of patients with SpA developed infusion reactions P = 0.126. The OR for development of infusion reactions in RA patients with baseline ANA positivity alone was 2.1. Infliximab without methotrexate and infliximab as monotherapy were associated with ORs of 3.1 and 3.6, respectively. Combining infliximab without methotrexate and ANA positivity yielded an OR for infusion reaction of 4.6. Lower age at disease onset and longer disease duration were associated with infusion reactions P = 0.012 and P = 0.036, respectively, but age, sex, C-reactive protein, erythrocyte sedimentation rate, Health Assessment Questionnaire and Disease Activity Score-28 at baseline were not. No predictors of infusions reactions were identified in SpA patients. RA patients treated with infliximab without methotrexate, and who are positive at baseline for ANAs are at increased risk for developing infliximab-related infusion reactions.

Electronic supplementary materialThe online version of this article doi:10.1186-ar2020 contains supplementary material, which is available to authorized users.

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Autor: Meliha C Kapetanovic - Lotta Larsson - Lennart Truedsson - Gunnar Sturfelt - Tore Saxne - Pierre Geborek


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