Prevalence of antinuclear antibodies in inflammatory bowel disease and seroconversion after biological therapy

María José García; Juan Carlos Rodríguez-Duque; Marta Pascual; Coral Rivas; Beatriz Castro; Sandra Raso; Marcos López-Hoyos; María Teresa Arias-Loste; Montserrat Rivero

doi:10.1177/17562848221077837

Prevalence of antinuclear antibodies in inflammatory bowel disease and seroconversion after biological therapy

Therap Adv Gastroenterol. 2022 Mar 2:15:17562848221077837. doi: 10.1177/17562848221077837. eCollection 2022.

Authors

María José García¹, Juan Carlos Rodríguez-Duque², Marta Pascual², Coral Rivas², Beatriz Castro², Sandra Raso³, Marcos López-Hoyos³, María Teresa Arias-Loste², Montserrat Rivero²

Affiliations

¹ Gastroenterology and Hepatology Department, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla s/n., CP 39008 Santander, Spain.
² Gastroenterology and Hepatology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
³ Immunology Department, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria de Valdecilla (IDIVAL), Santander, Spain.

Abstract

Background: Estimates of detectable antinuclear antibodies (ANA) prevalence vary widely, from 6% in healthy populations to 50-80% in patients with autoimmune disease. However, there is a lack of evidence about the overall prevalence in inflammatory bowel disease (IBD) and ANA seroconversion after the beginning of biological therapy.

Objectives: The aim of the study was to investigate the overall prevalence of ANA in IBD patients, their relationship with different treatments, clinical outcomes and the seroconversion rate of ANA in patients treated with biological therapy.

Methods: Ambispective observational study including all consecutive IBD patients was carried out. Information about the presence of ANA, disease phenotype, duration, activity, complications, and past and current treatments were transversally collected. Retrospectively, in patients with detectable ANA, data regarding previous ANA detection and the diagnosis of lupus-like syndrome (LLS) was gathered.

Results: A total of 879 IBD patients were included. We observed a detectable ANA prevalence of 13.6%. The presence of ANA was frequently associated with biological therapy (36/118) and decreased when immunomodulators were combined to this therapy (7/32). Of 78 patients with ANA prior to the beginning of biological therapy, a seroconversion rate of 28.8% was observed after a mean of 3.14 years. Only 1 patient suffered LLS.

Conclusion: Our study showed a prevalence of detectable ANA higher than the expected in healthy population. The presence of ANA was lower when immunomodulator therapy is associated. The ANA seroconversion rate is relevant after the initiation of biological treatment nevertheless, the risk of LLS appeared to be marginal.

Keywords: Crohn’s disease; anti-TNF; antinuclear antibodies; inflammatory bowel disease; lupus-like syndrome; seroconversion; ulcerative colitis; ustekinumab; vedolizumab.