Changes in ANA/ENA and Anti-dsDNA Autoantibodies During Adalimumab Therapy in Patients with Psoriasis: A Single-Centre Retrospective Study
Abstract
Background and Objectives: Tumour necrosis factor alpha (TNF-α) inhibitors are widely used for moderate-to-severe psoriasis and are known to induce autoantibody formation in a proportion of treated patients. This study evaluated changes in ANA/ENA and anti-dsDNA antibody levels in psoriasis patients receiving adalimumab therapy during the first 12 months of treatment. Materials and Methods: A retrospective single-centre study was conducted at the Dermatology and Sexually Transmitted Diseases Clinic of Riga 1st Hospital. Adult psoriasis patients treated with adalimumab for at least 12 months were included. ANA/ENA and anti-dsDNA IgG levels were assessed before treatment initiation and after one year of therapy. Statistical analysis was performed using IBM SPSS Statistics version 31, with p < 0.05 considered significant. Results: Seventy-one patients met the inclusion criteria (69%; 49 males, 31%; 22 females), with 41 patients aged ≥45 years and 30 patients aged <45 years. Anti-dsDNA IgG levels increased significantly after therapy in both females (0.9 IU/mL (IQR 9.4) vs. 15.0 (IQR 31.4) IU/mL; p =0.004) and males (0 (IQR 2.9) IU/mL vs. 3.1 (IQR 13.6) IU/mL; p =0.005), with the largest increase observed in patients aged ≥45 years (p < 0.001). ANA/ENA positivity rose from 6% at baseline to 23% after treatment. Patients with elevated autoantibody levels more frequently switched to another biologic agent; however, this association was not statistically significant. Conclusions: Adalimumab therapy was associated with increased anti-dsDNA IgG levels and ANA/ENA positivity after 12 months, confirming previous observations that TNF-α inhibition may be accompanied by treatment-associated autoantibody development. The clinical significance of these serological changes remains uncertain, and further prospective studies, including anti-drug antibody assessment, are needed to clarify their relationship with treatment outcomes and biologic immunogenicity.