Ventricular Arrhythmia With Cessation of Infliximab in a Patient With Ankylosing Spondylitis
Abstract
Infliximab is an anti-tumor necrosis factor alpha agent, which is indicated for the treatment of resistant ankylosing spondylitis (AS). We presented a patient with AS who developed ventricular tachycardia after premature cessation of infliximab. Ventricular tachycardia did not recur after restarting of infliximab treatment. This case report remarked the significance of the suppression of inflammation in AS since the subclinical ventricular involvement may potentially lead to the fatal arrhythmias.
Keywords
Arrhythmia, Arthritis, Seronegative Spondyloarthropathy, Syncope, Tumor Necrosis Factor Alpha
References
- 1. Papagoras C, Voulgari PV, Drosos AA. Atherosclerosis and cardiovascular disease in the spondyloarthritides, particularly ankylosing spondylitis and psoriatic arthritis. Clin Exp Rheumatol 2013;31:612-20.
- 2. Roifman I, Beck PL, Anderson TJ et al. Chronic inflammatory diseases and cardiovascular risk: a systematic review. Can J Cardiol 2011;27:174-82.
- 3. Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA et al. Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis. Semin Arthritis Rheum 2004;34:585-92.
- 4. Kang JH, Chen YH, Lin HC. Comorbidity profiles among patients with ankylosing spondylitis: a nationwide population-based study. Ann Rheum Dis 2010;69:1165-8.
- 5. Lagrand WK, Visser CA, Hermens WT et al. C-reactive protein as a cardiovascular risk factor: more than an epiphenomenon? Circulation 1999;100:96-102.
- 6. Blangy H, Sadoul N, Dousset B et al. Serum BNP, hs-C-reactive protein, procollagen to assess the risk of ventricular tachycardia in ICD recipients after myocardial infarction. European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. Europace 2007;9:724-9.
- 7. Lazzerini PE, Acampa M, Hammoud M et al. Arrhythmic risk during acute infusion of infliximab: a prospective, single-blind, placebo-controlled, crossover study in patients with chronic arthritis. J Rheumatol 2008;35:1958-65.
- 8. Brunner F, Kunz A, Weber U et al. Ankylosing spondylitis and heart abnormalities: do cardiac conduction disorders, valve regurgitation and diastolic dysfunction occur more often in male patients with diagnosed ankylosing spondylitis for over 15 years than in the normal population? Clin Rheumatol 2006;25:24-9.
- 9. Knight DM, Trinh H, Le J et al. Construction and initial characterization of a mouse-human chimeric anti-TNF antibody. Mol Immunol 1993;30:1443-53.
- 10. Maxwell LJ, Zochling J, Boonen A et al. TNF-alpha inhibitors for ankylosingspondylitis. Cochrane Database Syst Rev 2015;4:CD005468.