Cutaneous lupus erythematosus induced by golimumab therapy
Mustafa Al Izzi, Ashraf Reda
Mediclinic Welcare Hospital, Dubai, United Arab Emirates
A clinical case of a 63-year-old patient suffering from rheumatoid arthritis (RA) for more than ten years is presented. Earlier the patient received methotrexate, which induced the development of drug intolerance. In the exacerbation of RA, basic therapy with leflunomide 20 mg / day showed a slight effect. In connection with the multidrug resistance of the patient to traditional basic therapy, the inhibitor of tumor necrosis factor (TNF) -golimumab 50 mg subcutaneously, monthly, was prescribed. Three weeks after the second injection, the appearance of subacute cutaneous lupus erythematosus and discoid lupus was noted. The use of protein-based anti-TNF-α therapies such as antibodies and soluble TNF-α receptors is commonly associated with the induction of autoantibodies, whereas anti-TNF-induced lupus (ATIL) is rare. It can complicate the therapy with any TNF inhibitor. Cutaneous, renal and cerebral manifestations, as well as antibodies to double-stranded DNA, are more common in ATIL as compared to classical drug-induced lupus (DIL). Golimumab should be added to the list of drugs that can induce or exacerbate cutaneous lupus erythematosus.
Key words: discoid lupus, subacute cutaneous lupus erythematosus, golimumab, rheumatoid arthritis.
For citation: Al Izzi M., Reda A. Cutaneous lupus erythematosus induced by golimumab therapy // RMJ. MEDICAL REVIEW. 2017. № 1. P. 41–43.
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2. Atzeni F., Talotta R., Salaffi F. et al. Immunogenicity and autoimmunity during anti-TNF therapy // Autoimmun Rev. 2013. Vol. 12. P. 703.
3. Cemil B.C., Atas H., Canpolat F., Akca Y., Sasmaz R. Infliximab-induced discoid lupus erythematosus // Lupus. 2013. Vol. 22(5). P. 515–518.
4. Grönhagen C.M., Fored C.M., Linder M. et al. Subacute cutaneous lupus erythematosus and its association with drugs: a population-based matched case-control study of 234 patients in Sweden // Br J Dermatol. 2012. Vol. 167. P. 296.
5. Wilkerson E., Hazey M.A., Bahrami S., Callen J.P. Golimumab-exacerbated subacute cutaneous lupus erythematosus // Arch Dermatol. 2012. Vol. 148(10). P. 1186–1190.
6. Brunasso A., Aberer W., Massone C. Subacute lupus erythematosus during treatment with golimumab for seronegative rheumatoid arthritis // Lupus. 2014. Vol. 23(2). P. 201–203.
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