J Korean Geriatr Soc.  2013 Sep;17(3):134-137. 10.4235/jkgs.2013.17.3.134.

Adalimumab Induced Acute Exacerbation of Rheumatoid Arthritis Related Interstitial Lung Disease

• Park WK
• Lee YS
• Won S
• Kim HR
• Lee JH
• Lee KB
• Kim JH

• KMID: 2188251
• DOI: http://doi.org/10.4235/jkgs.2013.17.3.134

Abstract

A 69-year-old woman with 6 years history of seropositive rheumatoid arthritis (RA) and asymptomatic interstitial lung disease (ILD) began taking adalimumab for ongoing arthritis despite intakes of sulfasalazine and hydroxychloroquine for treatment. ILD progressed noticeably after 10 weeks of starting adalimumab. We discontinued adalimumab and added methylprednisolone 40 mg, and the patient's clinical findings gradually improved. The beneficial and adverse effects of tumor necrosis factor-alpha (TNF-alpha) inhibitors on RA associated ILD are unclear but this case reports adalimumab could abruptly exacerbate known ILD. We emphasize cautions on the use of adalimumab, one of the TNF-alpha inhibitors, in elderly RA patients with preexisting ILD.

Keyword

Adalimumab; Rheumatoid arthritis; Interstitial lung disease

MeSH Terms

Aged
Antibodies, Monoclonal, Humanized
Arthritis
Arthritis, Rheumatoid
Female
Humans
Hydroxychloroquine
Lung Diseases, Interstitial
Methylprednisolone
Sulfasalazine
Tumor Necrosis Factor-alpha
Adalimumab
Antibodies, Monoclonal, Humanized
Hydroxychloroquine
Methylprednisolone
Sulfasalazine
Tumor Necrosis Factor-alpha