A case of neurosarcoidosis secondary to treatment of etanercept and review of the literature

Berrios, Idanis; Jun-O’Connell, Adalia H.; Ghiran, Sorina; Ionete, Carolina

doi:10.1136/bcr-2014-208188

Cited by 13 publications

(9 citation statements)

References 14 publications

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“…MMF (∼30%) was applied to patients with scleroderma(-like) disease, probably because of its antifibrotic effects, and MTX (∼15%) in patients with neurosarcoidosis, overall with a moderate to poor response. In contrast, infliximab was successfully used in two patients with neurosarcoidosis [90, 94], consistent with several positive reports in the non-irAE situation [95, 96].…”

Section: Management Of Other Connective Tissue Disease/sarcoidosissupporting

confidence: 75%

Management of rheumatic complications of ICI therapy: a rheumatology viewpoint

Leipe

Mariette

2019

Rheumatology

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Since immune checkpoint inhibitors became the standard of care for an increasing number of indications, more patients have been exposed to these drugs and physicians are more challenged with the management of a unique spectrum of immune-related adverse events (irAEs) associated with immune checkpoint inhibitors. Those irAEs of autoimmune or autoinflammatory origin, or both, can involve any organ or tissue, but most commonly affect the dermatological, gastrointestinal and endocrine systems. Rheumatic/systemic irAEs seem to be less frequent (although underreporting in clinical trials is probable), but information on their management is highly relevant given that they can persist longer than other irAEs. Their management consists of anti-inflammatory treatment including glucocorticoids, synthetic and biologic immunomodulatory/immunosuppressive drugs, symptomatic therapies as well as holding or, rarely, discontinuation of immune checkpoint inhibitors. Here, we summarize the management of rheumatic/systemic irAEs based on data from clinical trials but mainly from published case reports and series, contextualize them and propose perspectives for their treatment.

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Section: Management Of Other Connective Tissue Disease/sarcoidosissupporting

confidence: 75%

Management of rheumatic complications of ICI therapy: a rheumatology viewpoint

Leipe

Mariette

2019

Rheumatology

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“…Case reports have suggested a possible association between nondemyelinating CNS events and neurosarcoidosis, CNS vasculitis, leptomeningitis, or meningoencephalitis. [9][10][11][12][13][14] Although the association between TNF inhibitor exposure and inflammatory CNS events has been postulated from previous studies, inflammatory CNS events can occur without TNF inhibitor exposure, and reports exist predating the TNF inhibitor treatment era. 15,16 Furthermore, inflammatory demyelinating CNS events may occur with a higher frequency in patients with autoimmune diseases as demonstrated by familial clusters and case-control disease studies.…”

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confidence: 99%

Association Between Tumor Necrosis Factor Inhibitor Exposure and Inflammatory Central Nervous System Events

et al. 2020

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Tumor necrosis factor (TNF) inhibitors are common therapies for certain autoimmune diseases, such as rheumatoid arthritis. An association between TNF inhibitor exposure and inflammatory central nervous system (CNS) events has been postulated but is poorly understood. OBJECTIVE To evaluate whether TNF inhibitor exposure is associated with inflammatory demyelinating and nondemyelinating CNS events in patients with an indication for TNF inhibitor use and to describe the spectrum of those CNS events. DESIGN, SETTING, AND PARTICIPANTS A nested case-control study was conducted using the medical records of patients with autoimmune diseases treated at 3 Mayo Clinic locations

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“…There are a few case reports of development of neurosarcoidosis in patients on other TNF-alpha inhibitors such as etanercept or infliximab [15–18]. These cases are reviewed in detail in Table 1.…”

Section: Discussionmentioning

confidence: 99%

A Case of Severe Symptomatic Central Nervous System Sarcoidosis Secondary to Treatment with Adalimumab

Nnodum

Hariri

Mavrommati

et al. 2019

Case Reports in Rheumatology

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Antitumor necrosis factor-α therapy has been used effectively in treatment of many inflammatory diseases such as rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease. There are increasing number of paradoxical reactions associated with this therapy that are being reported. We present the case of a 63-year-old male with psoriatic arthritis maintained on adalimumab and methotrexate (previous treatment trials of prednisone and leflunomide) who developed severe symptomatic sarcoidosis in the brain, liver, and lung. Upon discontinuation of adalimumab, the symptoms resolved but the imaging findings persisted. Although the development of sarcoidosis (usually in the lung, skin, and eyes) while on antitumor necrosis factor-α therapy is increasingly reported, the brain and liver are less commonly involved but should be borne in mind by physicians when extensive granulomatous lesions develop.

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A case of neurosarcoidosis secondary to treatment of etanercept and review of the literature

Cited by 13 publications

References 14 publications

Management of rheumatic complications of ICI therapy: a rheumatology viewpoint

Management of rheumatic complications of ICI therapy: a rheumatology viewpoint

Association Between Tumor Necrosis Factor Inhibitor Exposure and Inflammatory Central Nervous System Events

A Case of Severe Symptomatic Central Nervous System Sarcoidosis Secondary to Treatment with Adalimumab

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