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Various toxicities: 39 case reports A retrospective study identified 30 women and nine men aged 40–74 years who developed various toxicities while receiving anti-tumour necrosis factor (TNF)-α therapy [routes, dosages and outcomes not stated]. All patients had rheumatoid arthritis and were receiving antiTNF-α therapy with etanercept (34 patients) or adalimumab (5). They were also receiving disease-modifying antirheumatic drugs including methotrexate, prednisolone, sulfasalazine, hydroxychloroquine, leflunomide, azathioprine, ciclosporin and penicillamine. Adverse events occurred 1–81 months after the start of treatment. These included bacterial infection (19 patients), viral infection (7), mycobacterial infection (5), neuropathy (3), malignancy (3) and appendicitis (1). One patient, a 43-year-old woman, developed methotrexaterelated chronic hepatitis 28 months after starting etanercept, which resulted in discontinuation of treatment. Seventeen patients discontinued anti-TNF-α therapy because of adverse events, including 14 patients who discontinued treatment due to infection. Author comment: "[A] high percentage of patients with RA [rheumatoid arthritis] withdrew from anti-TNF therapy because of infectious adverse events." Yang C-T, et al. Discontinuation of anti-TNF-alpha therapy in a Chinese cohort of patients with rheumatoid arthritis. Clinical Rheumatology 31: 1549-1557, No. 11, Nov 2012. Available from: URL: http://dx.doi.org/10.1007/s10067-012-2047-8 803085830 Taiwan

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Reactions 20 Apr 2013 No. 1448