title: Etanercept-induced myositis: do we have to stop it? A surprising outcome.
abstract: We discuss a case of a 47-year-old man who presented with progressive proximal muscle weakness of the upper and lower extremities and unstable gait. He had been on etanercept for 6 months for severe psoriasis and psoriatic arthritis with good control of his disease. Serum creatine kinase (CK) level was found to be 5666 U/L and muscle biopsy showed a marked inflammatory myopathic process likely secondary to etanercept. He was started on high-dose steroids and advised to discontinue etanercept. Despite our recommendation, he never stopped using etanercept due to fear of a psoriasis flare. Three months later, he had significant improvement of clinical symptoms, normalised serum CK levels and discontinued prednisone.
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Bronx, New York, USA.
authors.forename: Hassan
authors.initials: H
authors.lastname: Tariq
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Bronx, New York, USA.
authors.forename: Bibi
authors.initials: B
authors.lastname: Ayesha
authors.affiliation: Department of Pathology, Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Weidenheim
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Bronx, New York, USA.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Franchin
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects*; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D003402:Creatine Kinase / Q000097:blood; D000068800:Etanercept / Q000009:adverse effects*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D009220:Myositis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D003402:Creatine Kinase; D000068800:Etanercept; D011241:Prednisone