Atrial fibrillation occurring in a patient taking etanercept plus methotrexate for rheumatoid arthritis.
A 57-year-old man with nodular rheumatoid arthritis was started on a combination of etanercept and methotrexate. After treatment for five months on this therapy, he presented with new-onset atrial fibrillation. While this report is anecdotal, any new drug warrants intense monitoring for unexpected toxicities in the post-marketing period. Etanercept is being tried in patients with congestive heart failure, where TNF-a seems to be increased. Further surveillance and caution are suggested in patients with known coronary artery disease or atrial dysrhythmia.
Wooten
M D
MD
Sections of Rheumatology and Cardiology, Department of Veterans Affairs Regional Medical Center,  Wilmington, Delaware,USA.
Reddy
G V
GV
Johnson
R D
RD
D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001281:Atrial Fibrillation / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008790:Metoprolol / Q000627:therapeutic use; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D008790:Metoprolol; D000068800:Etanercept; D008727:Methotrexate