Risk for Multiple Sclerosis with TNF Inhibitors

Tumor necrosis factor (TNF) inhibitors have been associated with demyelinating events and are contraindicated in patients with multiple sclerosis (MS; NEJM JW Neurol Aug 2020 and JAMA Neurol 2020; 77:937).

Now, Canadian investigators have conducted a population-based, nested, case-control study between 2000 and 2018 to compare the risk for MS between users and nonusers of TNF inhibitors among patients with rheumatic disease (RD) or inflammatory bowel disease (IBD). A total of 462 patients who developed MS during the study period (80% female; mean age, 47) were matched with 2296 controls without MS (60% female; mean age 47). TNF inhibitors for the treatment of RD and IBD were dispensed in the 2 years prior to the index date of MS onset to 18 …