Clinical course of central nervous system demyelinating neurological adverse events associated with anti-TNF therapy

J Neurol. 2021 Aug;268(8):2895-2899. doi: 10.1007/s00415-021-10460-6. Epub 2021 Feb 20.

Abstract

Previous studies have reported an association between anti-tumor necrosis factor alpha (anti-TNFα) treatment and central nervous system (CNS) events. We described eight patients presenting with demyelinating CNS events while on treatment with anti-TNFα for autoimmune diseases and followed up for a medium period of 4 years. Four patients presented with isolated demyelinating events, three patients fulfilled the criteria for multiple sclerosis (MS), and one patient showed worsening of pre-existing MS after anti-TNF therapy initiation. All patients except one, showed a good medium-term prognosis. Our observation supports an association between anti-TNFα treatment and demyelinating events and suggests that a prompt discontinuation of the drug may lead to a favorable demyelinating disease outcome.

Keywords: Biologics; Demyelination; Multiple sclerosis; Tumor necrosis factor alpha inhibitors.

MeSH terms

  • Autoimmune Diseases* / drug therapy
  • Central Nervous System / drug effects*
  • Demyelinating Diseases / chemically induced*
  • Humans
  • Multiple Sclerosis / chemically induced
  • Tumor Necrosis Factor Inhibitors / adverse effects*

Substances

  • Tumor Necrosis Factor Inhibitors