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Re: ANTI-TNF AGENT

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Vicki,

Thanks for that article.... I sent it on to my docs who are following

me.

BillG

>

>

> Anti-TNF Agent Linked to Case of New-Onset of Multiple Sclerosis

>

> 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 multiple sclerosis even after the drug has been withdrawn.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.

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