Rheumatology Medical News about spondyloarthropathies;anti-tumor necrosis factor therapy;paradoxical adverse events

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Paradoxical adverse events of anti-tumour necrosis factor therapy for spondyloarthropathies: A retrospective study
Rheumatology, 04/28/09

Fouache D et al. - Undesirable side effects like Inflammatory bowel disease (IBD), acute anterior uveitis (AAU) and psoriasis may appear with anti-TNF drugs. Even if they are, a priori, paradoxical, no evidence supports any paradoxical adverse events (PAEs) to be anti-TNF agent-specific in spondyloarthropathies (SpA).

Methods

Study was conducted to:
- describe the different PAEs that have occurred in a population of SpA pts treated with anti-TNF drugs, and
- to determine whether they are drug specific
Study group:
- 296 pts with SpA, treated with at least one anti-TNF drug (infliximab, etanercept or adalimumab), and
- 112 SpA pts treated only with conventional DMARDs who served as controls
Considering the cumulative time of exposure to each anti-TNF agent, the frequencies of new-onset PAEs in exposed pts were calculated

Results

Respective cumulative exposure times were 287, 290 and 62 patient-yrs for infliximab, etanercept and adalimumab
Following PAEs were observed:
- 5 psoriasis (3 under infliximab and 1 with etanercept or adalimumab)
- 3 AAU (1/100 patient-yrs, all under etanercept) and
- 4 IBD (3 under etanercept and 1 under infliximab)
No association among any of these PAEs and a specific anti-TNF agent
No difference in the overall PAEs among pts receiving anti-TNF drugs or controls, the latter experiencing 2 psoriasis and 3 AAU

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