Open Access Highly Accessed Research article

Autoantibody profile in rheumatoid arthritis during long-term infliximab treatment

Francesca Bobbio-Pallavicini1*, Claudia Alpini2, Roberto Caporali1, Stefano Avalle2, Serena Bugatti1 and Carlomaurizio Montecucco1

Author Affiliations

1 Department of Rheumatology University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy

2 Clinical Chemistry Laboratories University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy

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Arthritis Res Ther 2004, 6:R264-R272  doi:10.1186/ar1173

Published: 26 April 2004


The aim of the present study was to investigate the effect of long-term infliximab treatment on various autoantibodies in patients with rheumatoid arthritis. Serum samples from 30 consecutive patients, who were prospectively followed during infliximab and methotrexate therapy for refractory rheumatoid arthritis, were tested at baseline and after 30, 54 and 78 weeks. At these points, median values of the Disease Activity Score were 6.38 (interquartile range 5.30–6.75), 3.69 (2.67–4.62), 2.9 (2.39–4.65) and 3.71 (2.62–5.06), respectively. Various autoantibodies were assessed by standard indirect immunofluorescence and/or ELISA. Initially, 50% of patients were positive for antinuclear antibodies, and this figure increased to 80% after 78 weeks (P = 0.029). A less marked, similar increase was found for IgG and IgM anticardiolipin antibody titre, whereas the frequency of anti-double-stranded DNA antibodies (by ELISA) exhibited a transient rise (up to 16.7%) at 54 weeks and dropped to 0% at 78 weeks. Antibodies to proteinase-3 and myeloperoxidase were not detected. The proportion of patients who were positive for rheumatoid factor (RF) was similar at baseline and at 78 weeks (87% and 80%, respectively). However, the median RF titre exhibited a progressive reduction from 128 IU/ml (interquartile range 47–290 IU/ml) to 53 IU/ml (18–106 IU/ml). Anti-cyclic citrullinated peptide (CCP) antibodies were found in 83% of patients before therapy; anti-CCP antibody titre significantly decreased at 30 weeks but returned to baseline thereafter. In conclusion, the presence of anti-double-stranded DNA antibodies is a transient phenomenon, despite a stable increase in antinuclear and anticardiolipin antibodies. Also, the evolution of RF titres and that of anti-CCP antibody titres differed during long-term infliximab therapy.

anti-citrullinated peptide antibodies; anti-dsDNA antibodies; antinuclear antibodies; infliximab; rheumatoid factor