TNF-a blockers such as humanized antibodies (infliximab) or fully human antibodies (adalizumab) and a fusion protein between the TNF-aR and Ig (etanercept) recently have been used successfully for the treatment autoimmune diseases such as rheumatoid arthritis, Crohn's disease as well as psoriasis (Luger 2001). The experience using this compounds to treat LE is limited and one has carefully to consider their potential to induce autoantibodies which may cause exacerbation of the disease (Charles et al. 2000, Pisetsky 2000). However, one patient with rheumatoid arthritis and with SCLE was reported to be treated with etanercept which resulted in a significant improvement of the previously therapy-resistant skin lesions within 15 days (Fautrel et al. 2002). After 6 months, the rheumatoid arthritis remained improved, there were no signs of active lupus, ANA were stable and no anti-ds-DNA antibodies were present. Further controlled clinical trials ultimately will reveal the role of anti TNF-a strategies in the treatment of LE.
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