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Re-challenge with etanercept in patients with etanercept-induced neutropenia
Clinical Rheumatology, 08/16/2011
Clinical Article
Haroon M et al. – Although largely noted to be clinically insignificant in our patient series, the potential of drug-induced neutropenia in causing higher rate of infections do exist. Careful clinical and hematologic monitoring is the best way to recognize this adverse event.
Methods- Series of 5 patients who developed neutropenia with etanercept use
- All 5 were re-challenged with etanercept with mean follow up of 30 months
- Patients developed neutropenia within 2 months of starting etanercept
- 2 patients were eventually taken off etanercept; 1 of them needed switching to different form of TNF blockers, and second patient is in clinical remission with low-dose corticosteroids
- All our patients continued to have mild–moderate degree of neutropenia; however, they are being monitored very closely and they are enjoying complete disease remission
- Interesting to note that none of our patients had increased infections during re-challenge phase, even though they had grade 2 to grade 4 neutropenia
- Re-challenged these patients without any clinical complications, revealing that patients with mild to moderate neutropenia can be safely exposed to TNF blockers as long as they are monitored with regular cell count checks
