Neurologic Toxicities Associated with Tumor Necrosis Factor Inhibitors and Calcineurin Inhibitors.

Abstract:

:The calcineurin inhibitors cyclosporine and tacrolimus are used for their immunosuppressive effects. Neurotoxic side effects include tremor, paresthesia, and headache. Rarer neurotoxicities include seizure, posterior reversible encephalopathy syndrome, and encephalopathy. Tacrolimus tends to be more neurotoxic than cyclosporine. Management of toxicities associated with calcineurin inhibitors includes dose reduction, switching between calcineurin inhibitors, or switching to a calcineurin-free regimen. Tumor necrosis factor (TNF) inhibitors are used in autoimmune diseases. Management of demyelinating conditions among patients treated with anti-TNF should follow standard of care and withdrawal of the anti-TNF. This drug class should be avoided in patients with a history of demyelinating conditions.

journal_name

Neurol Clin

journal_title

Neurologic clinics

authors

Coe CL,Horst SN,Izzy MJ

doi

10.1016/j.ncl.2020.07.009

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

937-951

issue

4

eissn

0733-8619

issn

1557-9875

pii

S0733-8619(20)30061-X

journal_volume

38

pub_type

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