| Title: | Clinical Features and Genetic Risk of Demyelination Following Anti-TNF Treatment |
| Journal: | Journal of Crohn's and Colitis |
| Published: | 4 May 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/32497177/ |
| DOI: | https://doi.org/10.1093/ecco-jcc/jjaa104 |
| URL: | https://academic.oup.com/ecco-jcc/article-pdf/14/12/1653/34665111/jjaa104.pdf |
| Citations: | 13 (7 in last 2 years) as of 8 Aug 2024 |
Publication 12902
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Abstract
BACKGROUND: Anti-TNF exposure has been linked to demyelination events. We sought to describe the clinical features of demyelination events following anti-TNF treatment and to test whether affected patients were genetically predisposed to multiple sclerosis [MS].</p>
METHODS: We conducted a case-control study to describe the clinical features of demyelination events following anti-TNF exposure. We compared genetic risk scores [GRS], calculated using carriage of 43 susceptibility loci for MS, in 48 cases with 1219 patients exposed to anti-TNF who did not develop demyelination.</p>
RESULTS: Overall, 39 [74%] cases were female. The median age [range] of patients at time of demyelination was 41.5 years [20.7-63.2]. The median duration of anti-TNF treatment was 21.3 months [0.5-99.4] and 19 [36%] patients were receiving concomitant immunomodulators. Most patients had central demyelination affecting the brain, spinal cord, or both. Complete recovery was reported in 12 [23%] patients after a median time of 6.8 months [0.1-28.7]. After 33.0 months of follow-up, partial recovery was observed in 29 [55%] patients, relapsing and remitting episodes in nine [17%], progressive symptoms in three [6%]: two [4%] patients were diagnosed with MS. There was no significant difference between MS GRS scores in cases (mean -3.5 × 10-4, standard deviation [SD] 0.0039) and controls [mean -1.1 × 10-3, SD 0.0042] [p = 0.23].</p>
CONCLUSIONS: Patients who experienced demyelination events following anti-TNF exposure were more likely female, less frequently treated with an immunomodulator, and had a similar genetic risk to anti-TNF exposed controls who did not experience demyelination events. Large prospective studies with pre-treatment neuroimaging are required to identify genetic susceptibility loci.</p>
13 Keywords
- Adult
- Case-Control Studies
- Demyelinating Diseases
- Female
- Humans
- Male
- Middle Aged
- Multiple Sclerosis
- Prospective Studies
- Retrospective Studies
- Risk Factors
- State Medicine
- Tumor Necrosis Factor Inhibitors
27 Authors
- Simeng Lin
- Harry D Green
- Peter Hendy
- Neel M Heerasing
- Neil Chanchlani
- Benjamin Hamilton
- Gareth J Walker
- Graham A Heap
- Jeremy Hobart
- Roswell J Martin
- Alasdair J Coles
- Mark S Silverberg
- Peter M Irving
- Guy Chung-Faye
- Eli Silber
- J R Fraser Cummings
- Ellina Lytvyak
- Vibeke Andersen
- Andrew R Wood
- Jessica Tyrrell
- Robin N Beaumont
- Michael N Weedon
- Nicholas A Kennedy
- Alexander Spiers
- Timothy Harrower
- James R Goodhand
- Tariq Ahmad
1 Application
| Application ID | Title |
|---|---|
| 41588 | Genetic and phenotypic bases for gastrointestinal diseases and common adverse reactions to medicine |
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