XXXX Provoked by Etanercept: Report of 443 Possible Cases Combined from an @entity8787 Referral Center and the FDA.

@entity1 @entity31 @entity1050 @entity29 @entity3504 @entity792 @entity8787 @entity1499 @entity30
BACKGROUND: Anti-TNF therapies have revolutionized the treatment of autoimmune inflammatory conditions. Paradoxical treatment with these agents is associated with the development of de novo @entity792 . Less well recognized is the provocation of de novo @entity8787 by these agents. Etanercept is not effective for the treatment of @entity29 and may be more often reported with the development of @entity30 or @entity31 . AIM: This study assessed the association of new onset @entity8787 in @entity1 with receiving etanercept. METHODS: The Brigham and @entity1 's (BWH) @entity1 database and the FDA Adverse Event Reporting System were searched for cases of @entity8787 reported with etanercept. RESULTS: A total of 443 cases were identified: 5 pts at BWH (3 @entity1050 , 2 UC) and 438 (294 @entity1050 , 144 UC) reported to the FDA. Data which were most complete were pooled from 49 @entity1 . NSAID use was reported in 43  % and combination with @entity1499 in 29  %. Etanercept was discontinued in 34 pts and 19 required treatment with a different anti-TNF agent. Eight @entity1 had resolution of GI symptoms on discontinuation of etanercept. Therapy was continued in three @entity1 in response to @entity3504 therapy. CONCLUSION: Development of @entity8787 should be suspected in @entity1 receiving etanercept who develop GI symptoms. This phenomenon appears more commonly associated with initiation of @entity1050 . The clinical phenotype appears indistinguishable from usual patterns of @entity8787 . Unlike other autoimmune phenomenon associated with anti-TNF therapy, @entity8787 often does not resolve when the agent is discontinued. This tentative association requires further investigation.
