肿瘤坏死因子抑制剂暴露在MOGAD诊断是罕见的
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文摘
客观的评估潜在的TNF-inhibitors和MOGAD之间的联系
背景协会肿瘤坏死因子(TNF)抑制剂与女士曾被提出,而对MOG-IgG-associated疾病(MOGAD)在这些药物。我们最近遇到了两个患者MOGAD接收TNF-inhibitors,促使搜索类似案件在文献和临床实践。
设计/方法两例在梅奥诊所看到罗切斯特(双边视神经炎)和萨萨里大学医院(脑干综合症)。另外三例MOGAD呈现在治疗TNF-inhibitors通过Pubmed被确定。我们搜查了336 MOGAD患者的医疗记录看到梅奥诊所,评估他们是否TNF-inhibitors术治疗。
结果总共有5例。MOGAD演讲时的平均年龄40岁(范围、36-49);4/5是男性(80%)。从TNF-inhibitor起始MOGAD表示中位数时间为6.5年(范围,最近)。4患者停止了TNF-inhibitor由于MOGAD发病,随后两个MOGAD复发。而在另一个病人,与糖皮质激素尽管TNF-inhibitor维护神经系统症状消退。MOGAD呈现的频率在TNF-inhibitors治疗在梅奥诊所0.3%(1/336例)。
结论我们发现MOGAD TNF-inhibitors治疗期间不太可能出现。结果在这些患者似乎并没有受到TNF-inhibitor治疗持续时间或中止。这些发现表明TNF-inhibitor撤军的好处是不明显,与TNF-inhibitors中断对维持治疗的选择应该是加权的基于症状严重程度和活动状态潜在系统性疾病。考虑撤军时,免疫抑制与代理可能有效MOGAD和免疫介导性疾病最初由TNF-inhibitor管理,可以作为治疗双重目的。
脚注
披露:Redenbaugh博士没有披露。弗拉纳根博士的机构已收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会Alexion。弗拉纳根博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会基因泰克。弗拉纳根博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会地平线疗法。弗拉纳根博士已经收到个人薪酬在500 - 4999美元的范围为在演讲人药房服务时间。弗拉纳根博士的机构已经接到Viela生物研究支持。弗拉纳根博士non-compensated关系作为医学顾问委员会的一员河畔MOG项目相关的利益或活动。弗拉纳根博士non-compensated关系作为编辑委员会成员与神经科学杂志》上河畔相关利益或活动。弗拉纳根博士作为编辑委员会成员关系non-compensated河畔神经免疫学报告相关的利益或活动。Floris博士没有披露。 Dr. Zara has nothing to disclose. Dr. Bhatti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Receptos. Dr. Bhatti has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH LHON gene therapy study. Dr. Sanchez Moreno has nothing to disclose. Matthew Koster has nothing to disclose. Dr. Mariotto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech, Inc. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage Therapeutics, Inc. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astellas. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Prime Therapeutics. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche/Genentech. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MedImmune/Viela Bio. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB, Inc. Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman/LaRoche AG. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genetech. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for F. Hofman/LaRoche. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Pittock has received research support from Grifols. The institution of Dr. Pittock has received research support from NIH. The institution of Dr. Pittock has received research support from Viela Bio/MedImmune/Horizon. The institution of Dr. Pittock has received research support from Alexion Pharmaceuticals. The institution of Dr. Pittock has received research support from F. Hoffman/LaRoche/Genentech. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. John Chen has nothing to disclose. Alberto Cauli has nothing to disclose. Dr. Solla has nothing to disclose. Dr. Sechi has nothing to disclose.
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