In conclusion, through the joint analysis of BP immunogenicity in 4 autoimmune diseases treated with different BPs, we have identified clinical (heavy smoking, concomitant immunosuppressants, antibiotics, and infections) and genetic (a CXCL12 variant, HLA-DQA1*05 allele) risk factors associated with time to ADA occurrence pointing to more general mechanisms of immunogenicity. Here, ADA is linked to autoimmune disease.