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CNS disorders: 10 case reports In a study, 10 adult patients [six men and four women including two patients aged 50–55 years; exact ages of remaining eight patients not stated] were described, who developed various CNS disorders presenting as clinically isolated syndrome (CIS), relapsing-remitting multiple sclerosis (RRMS), worsening of pre-existing MS symptoms, isolated optic neuritis, isolated pontine demyelination, MS-like demyelination, opsoclonus myoclonus syndrome, autoimmune encephalitis or acute diffuse leukoencephalopathy while receiving adalimumab, etanercept, infliximab, golimumab or ipilimumab [routes, dosages and durations of treatments to reactions onsets not stated]. The patients had been receiving adalimumab (2 patients), etanercept (3 patients), infliximab (3 patients), golimumab (1 patient) and ipilimumab (1 patient) for psoriatic arthritis, Crohn’s disease, ankylosing spondylitis, seronegative spondyloarthritis, RRMS or advanced melanoma. Subsequently, the patients developed CIS (2 patients), RRMS (1 patients), CIS and RRMS (2 patients), isolated optic neuritis (1 patients), worsening of pre-existing MS symptoms (1 patients), opsoclonus myoclonus syndrome and autoimmune encephalitis (1 patient), isolated pontine demyelination (1 patient) and acute diffuse leukoencephalopathy (1 patient). Eight of the 10 patients showed MS-like demyelination on MRI. Due to the development of CNS disorders, treatment with adalimumab, etanercept, infliximab or golimumab were discontinued in nine of the 10 patients. Eight of the 10 patients were treated with unspecified steroid therapy, and these eight patients showed complete or partial resolution of symptoms. One of the 10 patients, who developed opsoclonus myoclonus syndrome and autoimmune encephalitis, did not recover despite etanercept discontinuation and treatment with unspecified immunoglobulins, plasma exchange and unspecified steroid therapy. One of the 10 patients, who developed acute diffuse leukoencephalopathy, died of the ADR. Cortese R, et al. Autoimmune neurological adverse events related to biological drugs: A case series. European Journal of Neurology 27 (Suppl. 1): 682 (plus poster) abstr. 803498472 EPO1255, May 2020. Available from: URL: https://doi.org/10.1111/ene.14308 [abstract]

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Reactions 29 Aug 2020 No. 1819