Inflammatory bowel disease and demyelination: more than just a coincidence?
Infliximab and other anti-TNF-α agents have been implicated for drug-induced demyelination in patients with inflammatory bowel diseases (IBDs). We evaluated existing data from MEDLINE and EMBASE and conducted a narrative review to investigate further the aforementioned association. Our literature search highlighted 34 case reports, 3 case-control studies, 1 prospective and 7 retrospective cohort studies published in English. Available data suggest that IBD patients can manifest demyelinating events in both central and peripheral nervous system, however, they are still insufficient to conclude whether anti-TNF-α therapies are an independent risk factor for demyelination. Prospective cohort studies with internal control groups are needed to estimate the true incidence of demyelinating disorders in patients with IBD and to elucidate if anti-TNF-α therapy increases further the risk of demyelination.
Department of Neurology, University of Ioannina, School of Medicine, Ioannina, Greece.
Aristeidis H
AH
Katsanos
Konstantinos H
KH
Katsanos
D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D002986:Clinical Trials as Topic; D003711:Demyelinating Diseases / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D007167:Immunotherapy / Q000706:statistics & numerical data*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000453:epidemiology*; D000069285:Infliximab; D015213:Neuroimmunomodulation; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab