Sensorineural hearing loss in ankylosing spondylitis treated with TNF blockers

Area of Science:

• Rheumatology
• Otolaryngology
• Pharmacology

Background:

• Sensorineural hearing loss (SNHL) is an uncommon but reported complication in ankylosing spondylitis (AS).
• The relationship between AS, anti-tumor necrosis factor (anti-TNF) therapies, and SNHL requires further investigation.

Purpose of the Study:

• To analyze the association between ankylosing spondylitis (AS), anti-TNF drug treatment, and the incidence of sensorineural hearing loss (SNHL).

Main Methods:

• Pure tone audiometry was performed on 28 consecutive AS patients undergoing treatment.
• Patients received either etanercept or infliximab (anti-TNF agents) alone or in combination with methotrexate (MTX).

Main Results:

• SNHL was diagnosed in 57.1% of patients.
• The SNHL rate was significantly higher in patients treated with anti-TNF plus MTX (100%) compared to anti-TNF alone (43%).
• A significant association was found between SNHL and treatment modality (p=0.011) and treatment duration (p=0.020).

Conclusions:

• Combination therapy with anti-TNF agents and MTX is associated with a significantly higher rate of SNHL in AS patients.
• Prolonged treatment duration, particularly with combination therapy, correlates with increased SNHL risk.
• Drug-induced vasculitis affecting the auditory system is a potential mechanism for SNHL in AS patients undergoing anti-TNF therapy.