Re: Anti-TNF Agent Linked to Case of New-Onset of MS

[Guest guest]

Hi ,its Becki.When s Rheumy gave us the application for Enbrel,he

let me describe it to my husband(said I should be a doctor)how many of

you have heard that?Any way he told us of two children who developed M.S.

one of the patiants was his and it turned out to not be M.S. but part of

her disease gone wrong,I have heard of a 7.5 yrold developing diabetes(scares

me to death)my brother,father,grand-father,all jeuvenile diabetis,my cousin,my

aunt,diabetis,most are dead because they were hard to treat.My kids get

tested twice a year,but I WORRY about Dave,I hear about the pred having

side affects similar to diabetes and then he is only 3 and he DRENCHES

a GOOD NIGHT pants,no matter high or low dose pred he is a PEE machine.A

major problem for us,If you have any advice on that one most appreciated.

Becki and 3 systemic

Georgina wrote:

Anti-TNF

Agent Linked to Case of New-Onset of Multiple Sclerosis

http://rheumatology.medscape.com/reuters/prof/2001/12/12.10/20011207clin015.html

WESTPORT, CT (Reuters Health) Dec 07

- A case report suggests that exposure to anti-TNF drugs might trigger

multiple sclerosis.

In a paper published in the current

issue of Neurology dated November 27, Dr. L. Sicotte and a

colleague from the University of California at Los Angeles note that previous

reports have shown that therapies aimed at inhibiting tumor necrosis factor

(TNF) can worsen multiple sclerosis (MS) or cause isolated demyelinating

events. Now it seems that anti-TNF agents might cause recurrent demyelinating

events or multiple sclerosis even after the drug has been withdrawn.

The clinicians describe a 21-year-old

woman with new onset MS "closely associated" with the start of treatment

with etanercept (Enbrel: Immunex) for refractory juvenile rheumatoid arthritis.

The patient had no family history for MS.

Nine months into etanercept treatment,

the patient complained of pain and decreased vision in her right eye and

was diagnosed with optic neuritis. The pain resolved and her vision returned

to normal following a 5-day course of high-dose IV methylprednisolone.

Two months later, the patient had no

new symptoms but new disease activity was apparent on cerebral MRI. Despite

discontinuing etanercept at this time, the patient developed new enhancing

lesions and neurologic symptoms over the next 6 weeks and met criteria

for "clinically definite relapsing remitting MS," the authors report.

It is entirely possible, they say,

that the use of etanercept and development of MS were coincidental in this

patient. It is also quite possible that the drug either triggered latent

or undiagnosed MS or caused MS to develop. The fact that the woman was

on etanercept for 9 months before the first attack suggests that she did

not have undiagnosed MS, the team writes.

Immunex has received a number of reports

of CNS demyelination associated with etanercept treatment, which led them

to issue a drug warning in October 2000.

"Clinicians who prescribe these types

of drugs should be aware of this potential side effect and should closely

monitor patients who develop demyelination to determine if more events

occur," Dr. Sicotte said. "This case is interesting because understanding

why certain individuals develop demyelination and/or multiple sclerosis

while receiving anti-TNF therapy may provide insight into the pathogenesis

of multiple sclerosis," she added.

Neurology 2001;57:1885-1888.