A patient with ankylosing spondylitis who developed infliximab-induced lupus and treated with etanercept

摘要

We read the paper by Diaz et al. [1] which reported patients with rheumatoid arthritis (RA) who developed drug-induced lupus erythematosus (DILE) who were treated with rituximab. Although treatment recommendations for DILE are not currently available, patients with RA may have different drug options like rituximab which is also approved for the treatment of RA. However, in patients with ankylosing spondylitis (AS), options for the treatment of DILE are highly restricted since biologies other than anti-TNF agents (i.e., rituximab) have no proven efficacy [2, 3]. The challenge is the treatment of patients with AS who developed DILE while on the treatment of anti-TNF drags; patients may inevitably exacerbate when TNF blockers stopped for the reversal of DILE symptoms and to continue non-steroid anti-inflammatory drugs (NSAIDs) alone may not be sufficient for the management.