ARP Rheumatology
ARP Rheumatology
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Article

ARP Rheumatology
Case-based Review

Multiple Sclerosis in rheumatic patients treated with tumor necrosis factor alpha inhibitors: a single-center retrospective case series and literature review

Authors

Garcia S, Fernandes B, Sousa JM, Terroso G, Guimarães J, Abreu P, Bernardes M

Abstract

Tumor necrosis factor alpha inhibitors (TNFi) are basilar treatments in a number of inflammatory rheumatic conditions and autoimmune phenomena such as de novo neuroinflammatory events were already described in these populations under TNFi. We conducted a single-center retrospective study in a cohort of rheumatic patients treated with TNFi to characterize neurological demyelinating/inflammatory disease in these patients. We report 3 cases (n= 744): all of them had spondyloarthritis, the onset of neurological manifestations occurred between 37 and 58 years old and all of them initially presented with an optic neuritis. The neurological symptoms emerged between 13 and 26 months after starting TNFi. All patients discontinued treatment with TNFi, but one resumed therapy with symptomatic worsening, having to interrupt treatment again. All patients, latter on, fulfilled multiple sclerosis (MS) McDonald criteria 1 and were diagnosed with relapsing-remitting MS. Our study support the prior view of a risk, disease-dependent or agent-dependent, although a causal relationship is yet to be enlightened.

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Publication:

2021-05-12

Pubmed:

Cite:

Salomé Garcia, Bruno Fernandes, José Maria Sousa, Georgina Terroso, Joana Guimarães, Pedro Abreu, Miguel Bernardes. Multiple Sclerosis in rheumatic patients treated with tumor necrosis factor alpha inhibitors: a single-center retrospective case series and literature review. ARP, Vol 46, nº3 2021:266-271. PMID: 34628460
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