Anti‐TNF alpha medications and neuropathy

• Published in: Journal of the peripheral nervous system 2015-12, Vol.20 (4), p.397-402
• Main Authors: Tsouni, Pinelopi, Bill, Olivier, Truffert, André, Liaudat, Christelle, Ochsner, François, Steck, Andreas J., Kuntzer, Thierry
• Format: Article
• Language: English
• Subjects: Adalimumab - adverse effects; Adalimumab - therapeutic use; Adult; Aged; anti‐TNF alpha; Autoimmune Diseases - drug therapy; demyelination; Electrodiagnosis; Etanercept - adverse effects; Etanercept - therapeutic use; Female; Humans; inflammation; Infliximab - adverse effects; Infliximab - therapeutic use; Male; Middle Aged; Neural Conduction - physiology; neuropathies; Peripheral Nervous System Diseases - chemically induced; Peripheral Nervous System Diseases - diagnosis; Peripheral Nervous System Diseases - physiopathology; Rheumatic Diseases - drug therapy; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Tumor necrosis factor-TNF
• ISSN: 1085-9489; 1529-8027
• DOI: 10.1111/jns.12147

We studied the clinical, electrophysiological, and pathological features, outcome, and frequency of anti‐tumor necrosis factor alpha (a‐TNF) medications‐induced neuropathies (ATIN) in patients with inflammatory disorders. Of 2,017 patients treated with a‐TNF medication, 12 patients met our inclusion criteria for a prevalence of 0.60% and an incidence of 0.4 cases per 1,000 person‐years. The median time from a‐TNF medication treatment to ATIN was 16.8 months (range 2–60 months). Six patients had focal or multifocal peripheral neuropathies. The other six had generalized neuropathies. For all, a‐TNF medication was stopped. Seven patients received immunoglobulin infusions. ATIN outcome was favorable in all but one patient. ATINs are rare and heterogeneous neuropathies. In 10 patients, the neuropathy was “inflammatory”, suggesting that it could be due to systemic pro‐inflammatory effects of a‐TNF agents.