Increased Risk for CNS Inflammatory Disease with TNF Inhibitors

Tumor necrosis factor inhibitors (TNFi), used for treating rheumatologic disease, have been associated with demyelinating events and are contraindicated in patients with multiple sclerosis (MS). To determine risk for developing a central nervous system (CNS) inflammatory disorder with TNFi exposure, investigators in this retrospective case control study searched more than 32,000 records for diagnostic codes of diseases with TNFi indications and for CNS inflammatory disorders. Included were 106 controls without an inflammatory CNS event and 106 patients with such events, 56 demyelinating events and 50 nondemyelinating events (e.g., meningitis, encephalitis, neurosarcoidosis, vasculitis).

Sixty percent of patients with inflammatory CNS disorde…