CNS Demyelination with TNF-α Blockers.
Tumor necrosis factor-α (TNF-α) blockers are a popular therapeutic choice in a number of inflammatory diseases. Thus far, five TNF- α blockers have been approved for clinical use (etanercept, infliximab, adalimumab, golimumab. and certolizumab). Despite being considered relatively safe, serious side effects associated with immune suppression have been reported, including central and peripheral nervous system (CNS) demyelinating disorders. It is still elusive whether these events are mere coincidence or a side effect of anti-TNF-α use. In this paper, we review the published case reports of CNS demyelination associated with anti-TNF-α therapy and present the follow-up of our 4 previously reported patients who developed neurologic symptoms suggestive of CNS demyelination after having received anti-TNF-α treatment. We also discuss the possible role of TNF-α blockers in demyelination.
Department of Neurology, Agii Anargiri General Oncological Hospital of Kifissia, Athens, Greece.|1st Department of Neurology, Athens National and Kapodistrian University, Aeginition Hospital, 74, Vas. Sophia's Ave, Athens, Greece.
Elissavet
E
Kemanetzoglou
1st Department of Neurology, Athens National and Kapodistrian University, Aeginition Hospital, 74, Vas. Sophia's Ave, Athens, Greece. eandread@med.uoa.gr.
Elisabeth
E
Andreadou
D000818:Animals; D003711:Demyelinating Diseases / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D014409:Tumor Necrosis Factor-alpha
Anti-TNF-α; Demyelination; Multiple sclerosis; Tumor necrosis factor