Table 2

ANA/dsDNA seroconversion and discontinuation rates of initial TNFi therapy

All patients (n=454)Etanercept (n=254)Infliximab (n=138)Adalimumab (n=62)Overall p-value
ANA-positive status prior to TNFi*151 (33.3%)83 (32.7%)51 (37%)17 (21.4%)NS
ANA seroconversion from negative to positive, n (%)83/454 (18.2%)30/254 (11.8%)43/138 (31.2%)10/62 (16.1%)<0.001†
Onset of ANA seroconversion, months, median (range)10.9 (1.3–80.0)12.5 (1.3–35.5)9.7 (1.4–48.6)12.0 (2.9–80.0)0.156
Pattern of ANA on seroconversion, n (%)‡
 Homogenous66/83 (79.5%)21/30 (70.0%)40 (93.0%)5 (50.0%)0.003§
 Nucleolar13/83 (15.7%)7/30 (23.3%)2 (4.7%)4 (40.0%)0.008¶
 Speckled3/83 (3.6%)2/30 (6.7%)0 (0.0%)1 (10.0%)0.167
 Peripheral1/83 (1.2%)0/30 (0.0%)1 (2.3%)0 (0.0%)0.625
New onset of anti-dsDNA antibodies, n (%)6/83 (7.2%)1/30 (3.3%)4/43 (9.3%)1/10 (10.0%)0.586
Appearance of anti-dsDNA antibodies, years, median (range)2.0 (0.8–4.2)3.12.1 (0.8–4.2)0.9NS
Drug discontinuation, n (%)283/454 (62.3%)153/254 (60.2%)92/138 (66.7%)38/62 (61.3%)0.447
ANA seroconverters from negative to positive, n (%)
 Primary non-response4/74 (5.4%)0/38 (0.0%)3/22 (13.6%)1/14 (7.1%)0.075
 Secondary non-response24/111 (21.6%)8/61 (13.1%)13/38 (34.2%)3/12 (25.0%)0.044**
 Adverse event18/87 (20.7%)8/51 (15.7%)8/24 (33.3%)2/12 (16.7%)0.198
  • *Refer to online supplementary figure 1 for change in ANA status for patients positive at onset during therapy.

  • †p<0.001 etanercept versus infliximab, p=0.026 infliximab versus adalimumab.

  • ‡Refer to online supplementary file for details on change in ANA patterns with therapy.

  • §p=0.009 etanercept versus infliximab, p=0.001 infliximab versus adalimumab.

  • ¶p=0.017 etanercept versus infliximab, p=0.001 infliximab versus adalimumab.

  • **p=0.013 etanercept versus infliximab.

  • TNFi, tumour necrosis factor inhibitor.