RESEARCH - Optic neuritis occuring with anti-TNF-alpha therapy

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Ann Rheum Dis. 2007 Sep;66(9):1255-8. Epub 2007 Apr 24.

Optic neuritis occurring with anti-tumour necrosis factor alpha therapy.

Simsek I, Erdem H, Pay S, Sobaci G, Dinc A.

Gulhane Military School of Medicine, Division of Rheumatology, Ankara, Turkey.

OBJECTIVE: Various demyelinating disorders have been reported in

association with anti-tumour necrosis factor alpha (TNFalpha) agents.

The objective of this study was to review the occurrence, clinical

features and outcome of optic neuritis (ON) during treatment with

anti-TNFalpha agents. METHODS: A PubMed search was conducted to

identify literature addressing the potential association between

anti-TNFalpha agents and ON, following our experience with a patient

having rheumatoid arthritis in whom ON developed while being treated

with infliximab. RESULTS: 15 patients including the case presented

here with ON in whom the symptoms developed following TNFalpha

antagonist therapy were evaluated. Eight of these patients had

received infliximab, five had received etanercept and two patients had

received adalimumab. Among them, nine patients experienced complete

resolution, and two patients had partial resolution, while four

patients continued to have symptoms. DISCUSSION: Patients being

treated with a TNFalpha antagonist should be closely monitored for the

development of ophthalmological or neurological signs and symptoms.

Furthermore, consideration should be given to avoiding such therapies

in patients with a history of demyelinating disease. If clinical

evaluation leads to the diagnosis of ON, discontinuation of the

medication and institution of steroid treatment should be a priority.

PMID: 17456525

http://www.ncbi.nlm.nih.gov/pubmed/17456525

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