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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Published on: November 4, 2010

Bronchospasm associated with anti-TNF treatment.

S Dubey¹, N Kerrigan, K Mills

¹Heart of England NHS Trust, Netherwood House, Solihull Hospital, Lode Lane, Solihull B91 2JL, UK. s.dubey@nhs.net

Clinical Rheumatology

|April 3, 2009

Summary

Bronchospasm is an emerging side effect of anti-TNF therapy in inflammatory arthritis patients. Smoking appears to be a key risk factor, with symptoms potentially more frequent and severe than previously thought.

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Area of Science:

Rheumatology
Pulmonology
Pharmacology

Background:

Breathing difficulties in inflammatory arthritis patients on anti-TNF agents have multifactorial causes.
While fibrosing alveolitis exacerbations are known, bronchospasm has not been thoroughly investigated.

Purpose of the Study:

To determine the incidence of bronchospasm in patients receiving anti-TNF agents.
To investigate the characteristics of respiratory issues in this patient group.

Main Methods:

Retrospective review of 421 inflammatory arthritis patients treated with anti-TNF agents.
Exclusion of cardiac, pleural, thromboembolic, and infectious causes of respiratory symptoms.

Main Results:

Seven patients (1.7%) developed bronchospasm attributed to anti-TNF treatment.
Four patients discontinued anti-TNF therapy; two required oral corticosteroids.
Two patients improved with increased inhaled beta-2 agonist and steroid therapy.

Conclusions:

Bronchospasm is a notable side effect of anti-TNF treatment, potentially more common and severe than previously recognized.
Smoking history appears to be a significant predisposing factor.
All three investigated anti-TNF agents were implicated in causing bronchospasm.