| dc.creator |
Lin, Simeng |
|
| dc.creator |
Hendy, Peter |
|
| dc.creator |
Heerasing, Neel |
|
| dc.creator |
Chanchlani, Neil |
|
| dc.creator |
Hamilton, Benjamin |
|
| dc.creator |
Walker, Gareth J. |
|
| dc.creator |
Ahmad, Tariq |
|
| dc.creator |
Heap, Graham A. |
|
| dc.creator |
Wood, A. R. |
|
| dc.creator |
Tyrrell, Jessica |
|
| dc.creator |
Beaumont, Robin N. |
|
| dc.creator |
Weedon, M. N. |
|
| dc.creator |
Kennedy, Nicholas A. |
|
| dc.creator |
Harrower, Timothy |
|
| dc.creator |
Goodhand, James R. |
|
| dc.date |
2020-11-02T10:18:35Z |
|
| dc.date |
2020-11-02T10:18:35Z |
|
| dc.date |
2020-06-04 |
|
| dc.date.accessioned |
2023-02-17T19:48:24Z |
|
| dc.date.available |
2023-02-17T19:48:24Z |
|
| dc.identifier |
Lin S et al. Clinical features and genetic risk of demyelination following anti-TNF treatment. J Crohns Colitis. 2020 Jun 4:jjaa104. doi: 10.1093/ecco-jcc/jjaa104. Epub ahead of print. |
|
| dc.identifier |
32497177 |
|
| dc.identifier |
10.1093/ecco-jcc/jjaa104 |
|
| dc.identifier |
https://rde.dspace-express.com/handle/11287/621512 |
|
| dc.identifier |
Journal of Crohn's and Colitis |
|
| dc.identifier.uri |
http://localhost:8080/xmlui/handle/CUHPOERS/242020 |
|
| dc.description |
Background: Anti-TNF exposure has been linked to demyelination events. We sought to describe the clinical features of demyelination events following anti-TNF treatment and test whether affected patients were genetically predisposed to multiple sclerosis (MS).
Methods: We conducted a case-control study to describe the clinical features of demyelination events following anti-TNF. We compared genetic risk scores (GRS), calculated using carriage of 43 susceptibility loci for MS, in 48 cases to 1219 patients exposed to anti-TNF who did not develop demyelination.
Results: Overall, 39 (74%) cases were female. The median age (range) of patients at time of demyelination was 41.5 years (20.7 - 63.2). The median duration of anti-TNF treatment was 21.3 months (0.5 - 99.4) and 19 (36%) patients were receiving concomitant immunomodulators. Most patients had central demyelination affecting the brain, spinal cord or both. Complete recovery was reported in 12 (23%) patients after a median time of 6.8 months (0.1 - 28.7). After 33.0 months of follow-up partial recovery was observed in 29 (55%) patients, relapsing and remitting episodes in 9 (17%), progressive symptoms in 3 (6%): 2 (4%) patients were diagnosed with MS. There was no significant difference between MS GRS scores in cases (mean -3.5 x 10-4, SD 0.0039) and controls (mean -1.1×10-3, SD 0.0042) (p=0.23).
Conclusions: Patients who experienced demyelination events following anti-TNF were more likely female, less frequently treated with an immunomodulator, and had a similar genetic risk to anti-TNF exposed controls who did not. Large prospective studies with pre-treatment neuroimaging are required to identify genetic susceptibility loci. |
|
| dc.description |
published version, accepted version (12 month embargo), submitted version |
|
| dc.language |
en |
|
| dc.publisher |
Silverchair Information Systems |
|
| dc.relation |
https://academic.oup.com/ecco-jcc/article-lookup/doi/10.1093/ecco-jcc/jjaa104 |
|
| dc.rights |
© The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com. |
|
| dc.subject |
Demyelination |
|
| dc.subject |
anti-TNF |
|
| dc.subject |
tumor necrosis factors |
|
| dc.subject |
multiple sclerosis |
|
| dc.title |
Clinical features and genetic risk of demyelination following anti-TNF treatment |
|
| dc.type |
Journal Article |
|
| dc.type |
In press (epub ahead of print) |
|