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Optic neuritis occurring with anti-tumour necrosis factor alpha therapy
Ismail Simsek1, Hakan Erdem, Salih Pay
1Gulhane Military School of Medicine, Division of Rheumatology, Ankara, Turkey.
Anti-tumour necrosis factor alpha (TNFalpha) agents can cause optic neuritis (ON), a demyelinating disorder. Patients on these drugs require monitoring for neurological symptoms, and those with a history of demyelination should avoid them.
Area of Science:
- Neuro-immunology
- Ophthalmology
Background:
- Anti-tumour necrosis factor alpha (TNFalpha) agents are used to treat inflammatory conditions.
- Demyelinating disorders, including optic neuritis (ON), have been anecdotally linked to anti-TNFalpha therapy.
Observation:
- This review evaluated 15 patients who developed ON during anti-TNFalpha treatment.
- The agents involved were infliximab, etanercept, and adalimumab.
- Onset of ON occurred after initiation of anti-TNFalpha therapy.
Findings:
- Nine patients achieved complete resolution of ON symptoms.
- Two patients experienced partial resolution.
- Four patients had persistent symptoms despite treatment.
Implications:
- Close monitoring for ophthalmological and neurological symptoms is crucial for patients on anti-TNFalpha agents.
- Consideration should be given to avoiding anti-TNFalpha therapy in patients with a history of demyelinating disease.
- Discontinuation of anti-TNFalpha agents and prompt steroid treatment are recommended upon diagnosis of ON.
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