Updated: Nov 10
How taking the wrong medication for your autoimmune condition could actually give you another autoimmune condition.
Finding the right autoimmune medication is already a challenging undertaking. For 43% of patients, methotrexate, a common first-line drug, makes no improvement to their autoimmune disease. No response to a drug can be discouraging, but much scarier and more dangerous is an adverse reaction.
We're all familiar with the laundry list of potential side effects rattled off at lightning speed in drug commercials or densely packed in pamphlets. We've heard so many of these side effects already: nausea, mood swings, the list goes on. But many are unfamiliar with autoimmunity as a side effect.
Starting a new drug, you're probably preoccupied with your own autoimmune condition. So developing another one, as a result of treatment no less, comes as a shock to many patients.
However, drug-induced autoimmunity is not all that uncommon. What's worse, it can go unnoticed, because the symptoms are often similar to the those of the pre-existing autoimmune condition you're trying to treat with the drug. an adverse reaction that gradually develops over months. It's often mild and reversible within a few months of stopping the medication, but the damage it's capable of causing can have lasting effects. Some cases can even be life-threatening.
Among the more-studied drug-induced autoimmune conditions is drug-induced lupus. It takes several months or years on a drug to develop, so if you've been taking the associated medications, keep an eye out for the symptoms, which can often be confused with the symptoms of your pre-existing autoimmune condition.
How common is drug-induced autoimmunity? For rheumatoid arthritis patients taking inflixumab in a clinical trial, less than 1% developed lupus-like symptoms. However, the reported rates vary significantly across medications and their dosages, some rates going as high as 20%. There are no significant differences in these reported rates between men and women.
While drug-induced lupus disappears within 6 months of stopping the medication, other drug-induced autoimmune conditions can be more persistent. Drug-induced psoriasis is one example of a recurring condition (i.e. when triggered by similar beta-blocker drugs). If you've ever discontinued a drug for this reason, it's important you share that with your doctor.
Listen to Jenni's story as an RA Warrior with autoimmune-induced psoriasis. She's living proof of how to bounce back from drug-induced autoimmunity.
The mechanisms of drug-induced autoimmunity are still poorly understood, though a few theories have been raised. With single-cell RNA sequencing, we hope to better understand patient-treatment matching for rheumatoid arthritis drugs, so stories like Jenni's are not repeated.
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