Clinical Characteristics and Management of Drug-Induced Lupus in Patients Receiving Tumor Necrosis Factor Inhibitor Therapy.

Introduction Drug-induced lupus (DIL) is an autoimmune condition triggered by exposure to certain medications, leading to the emergence of clinical features that resemble those of systemic lupus erythematosus (SLE). This study aims to investigate the clinical characteristics, management strategies, and outcomes of patients who develop DIL during tumor necrosis factor inhibitor (TNFi) therapy. Methods We conducted a retrospective case series involving 15 patients who developed positive anti-double-stranded DNA (anti-dsDNA) antibodies while undergoing TNFi therapy between 2015 and 2023. Clinical data were collected and analyzed to assess the relationship between TNFi therapy and the onset of DIL symptoms. Results The case series included 15 patients (13 females and two males) with a mean age of 42.13 years. The primary diagnoses were ankylosing spondylitis (AS) (46.66%), rheumatoid arthritis (RA) (40%), and psoriatic arthritis (PsA) (13.33%). The mean duration from TNFi initiation to the detection of anti-dsDNA positivity was 5.13 years. Two patients (13.33%) exhibited clinical manifestations of DIL; however, no major organ involvement was observed. Sixty percent of patients continued with the same TNFi without disease activation, while 33% switched medications. Conclusion TNFi-induced DIL typically presents with mild symptoms. Both continuation and switching of TNFi therapy can be considered without significant exacerbation of symptoms. Management should be individualized based on clinical and laboratory findings. Further research with larger patient cohorts is warranted to determine optimal management strategies.