Eternacept for the treatment of patients with rheumatoid arthritis and concurrent interstitial lung disease.

Abstract:

WHAT IS KNOWN AND OBJECTIVE:Tumour necrosis factor-α (TNF-α)-blocking agents are increasingly used in the management of refractory rheumatoid arthritis (RA). Although effective, they are associated with rare but potentially fatal adverse effects, including interstitial lung disease (ILD). In patients with pre-existing ILD, eternacept (ETN) monotherapy is often regarded as a suitable choice. Other anti-TNF-α blockers such as infliximab and adalimumab, are used in combination therapy with methotrexate (MTX) in most of the cases. We report on a case of fatal exacerbation of ILD in a patient given ETN monotherapy and review the literature on ETN-associated ILD. METHODS:We report on a case of a 75-year-old male with RA who developed severe ILD after the introduction of ETN, and we undertook a literature search to identify other reports of similar cases. We then critically assessed those reports. RESULTS AND DISCUSSION:In addition to our case, 11 other patients have been reported to have developed ILD in association with the use of ETN. Six patients had pre-existing ILD. Although four patients received MTX, eight patients developed severe ILD without MTX. Ten patients recovered after termination of ETN, although two patients died. WHAT IS NEW AND CONCLUSION:Although ETN is often regarded as safe for patients with ILD, our case and the literature reports suggest that caution is still required.

journal_name

J Clin Pharm Ther

authors

Horai Y,Miyamura T,Shimada K,Takahama S,Minami R,Yamamoto M,Suematsu E

doi

10.1111/j.1365-2710.2010.01234.x

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

117-21

issue

1

eissn

0269-4727

issn

1365-2710

journal_volume

37

pub_type

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