Autoimmune diseases induced by biological agents: a double-edged sword?

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Biological agents are widely used for rheumatic and systemic autoimmune diseases.
• Paradoxical induction of autoimmune diseases secondary to biological therapies is increasingly reported, predominantly with anti-TNF agents.

Purpose of the Study:

• To analyze the clinical characteristics and outcomes of autoimmune diseases developing after biological therapies.
• To review cases documented through a Medline search as part of the BIOGEAS project.

Main Methods:

• A baseline Medline search was conducted.
• Data from over 800 cases of autoimmune diseases secondary to biological therapies (updated July 15, 2009) were analyzed.

Main Results:

• A wide spectrum of systemic and organ-specific autoimmune diseases were observed.
• Most cases (nearly 75%) resolved after cessation of biological therapy.
• Interstitial lung disease, inflammatory ocular disease, and CNS demyelinating diseases showed the poorest outcomes.

Conclusions:

• Biological therapies can induce various autoimmune conditions.
• Early recognition and cessation of therapy are crucial for favorable outcomes.
• Specific induced autoimmune diseases carry a significant risk of poor prognosis.