Antiphospholipid syndrome autoantibodies induction after treatment with anti-TNF alpha therapy in patients with IBD.

ABSTRACT

INTRODUCTION: AntiTNF treatment has been broadly linked with autoantibodies and autoimmune disorders development. After the clinical observation of aPTT (Activated Partial Thromboplastin Clotting Time) prolongation in our cohort of IBD patients treated with antiTNF, we sought to determine the presence of antiphospolipid antibodies in our population, along with antiphospholipid syndrome (APS) occurrence. METHODS: We included in the study 289 patients treated with anti-TNFα antibodies. RESULTS: 24 of 289 patients presented a prolonged aPPT (8.3%) after starting antiTNF treatment. We found antiphospholipid antibodies in 70.8% (17/24) of patients with aPTT prolongation. No major thrombotic events were reported although 1 patient met criteria for APS because of persistent antiphospolipid antibodies and 2 miscarriages. Another patient was diagnosed with lupus-like syndrome. CONCLUSION: AntiTNF treatment is associated with the induction of various antibodies, among them, antiphospholipid antibodies. However, a very low number of patients develop APS. Testing for antiphospholipid antibodies patients with prolonged aPPT could identify those at risk and lead to individualized treatment. Additional prospective studies are necessary to acquire more information.