Increased prevalence of allergic sensitisation in rheumatoid arthritis patients treated with anti-TNFalpha

Introduction. – Tumour necrosis factor alpha (TNF) has emerged as a therapeutic target in chronic inflammatory disorders characterised by a Th1 type immune response, such as rheumatoid arthritis (RA). The presence of allergic disease in these patients could be influenced both by the presence of RA and anti-TNF therapy. Our aim was to evaluate the prevalence of sensitisation to airborne allergens and allergic disease in RA patients, with and without anti-TNF treatment. Methods. – RA patients with (N = 20) and without (N = 20) anti-TNF therapy (groups T and R) were enrolled. Healthy controls (N = 60, group C) were randomly selected from the general population. All participants answered a standardised questionnaire to assess the prevalence of allergic disease and had skin prick tests (SPT) with a standard panel of airborne allergen extracts. Results. – Significant differences were found in the prevalence of positive SPT between groups T and R (70% vs 35%, p = 0.027) and groups T and C (70% vs 36.7%, p = 0.009), but not between groups R and C. The prevalence of allergic disease was similar in the three groups. Groups T and R had similar gender and age distribution, disease duration, disease activity score (DAS28), erythrocyte sedimentation rate and serum C-reactive protein. Conclusions. – Increased prevalence of sensitisation to airborne allergens in RA patients treated with anti-TNF was found. The clinical impact of the positive SPT following anti-TNF initiation has now to be assessed.