title: Etanercept and demyelinating disease in a patient with psoriasis.
abstract: The tumor necrosis factor-alpha antagonist (TNF-alpha) etanercept has been approved for the treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis. Earlier reports on the use of etanercept or infliximab in patients with rheumatoid arthritis, psoriatic arthritis, or juvenile rheumatoid arthritis suggested an increased risk of demyelinating disease. It is imperative that dermatologists have a keen awareness of this possible adverse event given the increased use of this class of drugs. We report a case of demyelinating disease occurring in a patient treated for psoriasis. The relation of TNF-alpha antagonist therapy to demyelinating disease/multiple sclerosis is explored. It is recommended that patients be diligently screened before starting TNF-alpha antagonist therapy and that vigilance for symptoms of demyelinating disease/multiple sclerosis be included in follow-up examinations during treatment with these drugs.
authors.affiliation: Department of Dermatology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, New York, USA.
authors.forename: Sean A
authors.initials: SA
authors.lastname: Sukal
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Nadiminti
authors.forename: Richard D
authors.initials: RD
authors.lastname: Granstein
mesh_terms: D000293:Adolescent; D038524:Diffusion Magnetic Resonance Imaging; D000068800:Etanercept; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D011565:Psoriasis / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept