Drug-induced rheumatic diseases

Abstract

It is important to recognise that drugs used in other specialties may induce rheumatic disease and vigilance on making a diagnosis is the key.

Rheumatic diseases induced by drugs and environmental factors: the state-of-the-art – part two

“…Among newer medications that can cause vasculitis, special attention is paid to TNF inhibitors and new small molecules, i.e. kinase inhibitors: gefitinib used in oncology and masitinib, analyzed in terms of the treatment effectiveness in rheumatoid arthritis [2, 3]. …”

“…The most frequently mentioned drugs are TNF inhibitors including etanercept and adalimumab. These drugs cause full-blown disease with the occurrence of anti-Jo-1 antibodies, but there is also a case of a patient with clinical symptoms without the presence of antibodies in serum [2, 12]. Liu et al [13] presented a case of a 46-year-old patient who reported DM symptoms after etanercept administration.…”

“…Statins may be a cause of the whole spectrum of muscle damage from focal lesions to full-blown DM [2, 14, 15]. Other drugs that cause myositis are hydroxyurea, which in 70 publications investigated by Seidler and Gottlieb [16] accounted for 51% of DM cases, but also interferons, gonadoliberin, D-penicillamine, the tyrosine kinase inhibitor sorafenib [2]; a new drug used to treat hepatitis B – clevudine [17]; ipilimumab – a human monoclonal antibody used in the treatment of metastatic melanoma [18]; and zoledronic acid, prescribed for the treatment of osteoporosis [19]. …”

“…An example is Sjögren’s syndrome, for which the occurrence has been associated with the use of hydralazine [23] and phenobarbital [2]. Among environmental factors, mainly viral infections, in particular, Epstein-Barr virus (EBV) and CMV [24], as well as exposure to acrylamide, have an influence on the induction of Sjögren’s syndrome [25].…”

“…Vaccination against influenza, tuberculosis, hepatitis B, and HPV [2, 30, 33, 34] are mentioned among these.…”