Neurologic Toxicities Associated with Tumor Necrosis Factor Inhibitors and Calcineurin Inhibitors

Coe, Christopher L.; Horst, Sarah; Izzy, Manhal

doi:10.1016/j.ncl.2020.07.009

Cited by 11 publications

(11 citation statements)

References 89 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Changes in OCT findings in association with adalimumab use found in this study potentially suggest a neurotoxic side effect. Although rare, TNF-alpha inhibition-related neurotoxicities/neuropathies, such as multiple sclerosis, Guillain-Barre and Miller-Fischer syndrome, chronic inflammatory demyelinating 14 . In a large safety analysis of adalimumab, it is estimated that the incidence of demyelinating disorders is less than 0.1 per 100 patient-years 15 .…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography changes in ankylosing spondylitis patients on long-term adalimumab treatment

Yavuz

Özer

Sarı

et al. 2022

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

Ankylosing spondylitis, a form of axial spondyloarthritis (SpA), is a chronic inflammatory rheumatic disease and manifests itself by inflammatory back pain, radiographic sacroiliitis, and excess spinal bone formation, as well as non-skeletal manifestations such as uveitis, inflammatory bowel disease (IBD), or psoriasis 1 . Reported prevalence rates range between 0.1 and 0.5% 1,2 .Tumor necrosis factor-alpha (TNF-alpha) is a cytokine with a key regulatory role in the inflammatory response, and impaired regulation of TNF-alpha has been suggested to have a role in the pathogenesis of inflammatory conditions. Blocking the action of TNF-alpha has been used in the treatment of chronic inflammatory conditions, including ankylosing spondylitis. Adalimumab is a recombinant human IgG1 monoclonal antibody, specific for human TNF-alpha.Despite its revolutionary benefits in rheumatologic disease, adverse effects such as ocular complications, severe infection, demyelinating conditions, malignancies, a lupus-like syndrome, induction of autoantibodies, injection site reactions, and heart failure have been reported with the use of TNF-alpha inhibitors 3 . Reported ocular side effects include periorbital infection, oculomotor nerve palsy, optic neuritis, central vein occlusion, as well as a paradoxical adverse event uveitis [4][5][6][7][8] . Most data on ocular side effects come from anecdotal reports, and pathophysiological processes are mostly unknown³; thus, ocular structural changes during long-term TNF-alpha inhibitor use may shed light on the pathogenesis of these conditions.Optical coherence tomography (OCT) is a practical technique widely used in clinical practice, which enables detailed examination of the eye and allows the thicknesses of the choroid, retina, and peripapillary retinal nerve fiber layer (RNFL) to be measured.

show abstract

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography changes in ankylosing spondylitis patients on long-term adalimumab treatment

Yavuz

Özer

Sarı

et al. 2022

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

show abstract

“…Tacrolimus is primarily used in organ transplantation 62 . Tacrolimus toxicity can cause neuropathy, often accompanied by a tremor, headache, and occasionally seizures 63 . The mechanism of toxicity is thought to be decreasing calcineurin’s role in modulating Na + /K + ATPase activity.…”

Section: Chemotherapy-induced Peripheral Neuropathymentioning

confidence: 99%

“…Estimates vary widely, but up to 40% of patients treated with tacrolimus develop a chronic multifocal demyelinating neuropathy 64 . Risk factors for tacrolimus neurotoxicity include peak blood serum levels of the drug, liver failure, and specific polymorphisms in the MDR1 gene 63 . There are reports of patients improving after cessation of tacrolimus and treatment with IVIg 65 …”

Section: Chemotherapy-induced Peripheral Neuropathymentioning

confidence: 99%

“…64 Risk factors for tacrolimus neurotoxicity include peak blood serum levels of the drug, liver failure, and specific polymorphisms in the MDR1 gene. 63 There are reports of patients improving after cessation of tacrolimus and treatment with IVIg. 65…”

Section: Key Pointsmentioning

confidence: 99%

“…62 Tacrolimus toxicity can cause neuropathy, often accompanied by a tremor, headache, and occasionally seizures. 63 The mechanism of toxicity is thought to be decreasing calcineurin's role in modulating Na + /K + ATPase activity. Estimates vary widely, but up to 40% of patients treated with tacrolimus develop a chronic multifocal demyelinating neuropathy.…”

Section: Key Pointsmentioning

confidence: 99%

See 2 more Smart Citations

Toxic Neuropathies

McNeish,

Kolb

2023

CONTINUUM: Lifelong Learning in Neurology

View full text Add to dashboard Cite

Objective The purpose of this article is to provide an overview and update on the most clinically relevant toxic neuropathies. Latest Developments Broadly, toxic neuropathies were previously quite rare with the notable exception of neuropathy from alcohol or older chemotherapeutics. The development of newer therapies, particularly immunotherapy to treat malignancy, has resulted in a substantial increase in the occurrence of toxic neuropathies that require timely recognition and treatment. The understanding of other toxic neuropathies continues to evolve, such as statin-induced neuropathy, which new evidence suggests is much less common than previously suspected. Essential Points Toxic neuropathies can be caused by medications, supplements, and recreational substances that injure peripheral nerves. Medications have evolved in the past 2 decades, as have the types of neuropathies that can be seen as related toxicities. In some areas of medicine, new classes and generations of drugs are associated with a lower incidence of toxic neuropathy.

show abstract

A Comprehensive Review of Calcineurin Inhibitors Used for Immunosuppression in Cardiac Transplantation

Engwenyu

Anderson

2021

Handbook of Experimental Pharmacology

View full text Add to dashboard Cite

Neurologic Toxicities Associated with Tumor Necrosis Factor Inhibitors and Calcineurin Inhibitors

Cited by 11 publications

References 89 publications

Optical coherence tomography changes in ankylosing spondylitis patients on long-term adalimumab treatment

Optical coherence tomography changes in ankylosing spondylitis patients on long-term adalimumab treatment

Toxic Neuropathies

A Comprehensive Review of Calcineurin Inhibitors Used for Immunosuppression in Cardiac Transplantation

Contact Info

Product

Resources

About