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Titolo:
Etanercept therapy for immune-mediated cochleovestibular disorders: Preliminary results in a pilot study
Autore:
Rahman, MU; Poe, DS; Choi, HK;
Indirizzi:
Massachusetts Gen Hosp, Rheumatol Unit, Dept Med, Boston, MA 02114 USA Massachusetts Gen Hosp Boston MA USA 02114 Dept Med, Boston, MA 02114 USA Massachusetts Gen Hosp, Dept Surg, Boston, MA 02114 USA Massachusetts Gen Hosp Boston MA USA 02114 ept Surg, Boston, MA 02114 USA Massachusetts Eye & Ear Infirm, Boston, MA 02114 USA Massachusetts Eye & Ear Infirm Boston MA USA 02114 , Boston, MA 02114 USA Harvard Univ, Sch Med, Boston, MA USA Harvard Univ Boston MA USAHarvard Univ, Sch Med, Boston, MA USA
Titolo Testata:
OTOLOGY & NEUROTOLOGY
fascicolo: 5, volume: 22, anno: 2001,
pagine: 619 - 624
SICI:
1531-7129(200109)22:5<619:ETFICD>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
INNER-EAR DISEASE; SENSORINEURAL HEARING-LOSS; MENIERES-DISEASE; RHEUMATOID-ARTHRITIS; METHOTREXATE; RECEPTOR; PROTEIN; HEAT-SHOCK-PROTEIN-70; GRANULOMATOSIS; ANTIBODIES;
Keywords:
cochleovestibular disorders; etanercept; immune-mediated inner-ear disease; sensorineural hearing loss;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Rahman, MU Massachusetts Gen Hosp, Rheumatol Unit, Dept Med, Bulfinch 165,Fruit St, Boston, MA 02114 USA Massachusetts Gen Hosp Bulfinch 165,Fruit StBoston MA USA 02114
Citazione:
M.U. Rahman et al., "Etanercept therapy for immune-mediated cochleovestibular disorders: Preliminary results in a pilot study", OTOL NEURO, 22(5), 2001, pp. 619-624

Abstract

Objective: Immune-mediated cochleovestibular disorders (IMCVDs) continue to present a management challenge to the otolaryngologist. Antirheumatic agents, commonly used for IMCVDs, are associated with variable efficacy and sometimes with serious side effects. The authors describe the preliminary result of their experience in patients with IMCVDs who have been treated with etanercept, a tumor necrosis factor alpha receptor blocker, recently approved by the United States Food and Drug Administration for the treatment of rheumatoid arthritis. Study Design: Retrospective case series. Setting: Tertiary care hospital. Patients: Twelve patients suspected of having IMCVD who did not respond toconventional therapies or experienced side effects of the conventional therapies. Intervention: Etanercept 25 mg by subcutaneous injection twice per week. Main Outcome Measures: The main outcome measurement was assessment of hearing change by air conduction pure tone audiograms and/or word discrimination. When present, vertigo, tinnitus, and aural fullness were assessed as well. Results: Follow-up of more than 5 months was available for all patients (range, 5-12 months). Eleven (92%) of 12 patients had improvement or stabilization of hearing and tinnitus, seven (88%) of eight patients who had vertigo and eight (89%) of nine patients who had aural fullness had resolution orsignificant improvement of their symptoms. The benefit persisted until thelast visit (5-12 months after etanercept was begun). The condition of one patient improved dramatically at first but deteriorated after 5 months. Thepatient's hearing was rescued and stabilized with the addition of leflunomide to etanercept. Similarly, three other patients required a second antirheumatic agent to stabilize their hearing. There were no significant side effects from the etanercept therapy. Conclusions: Our limited data suggest that etanercept therapy is safe and may be efficacious in carefully selected patients with IMCVDs, at least on a short-term basis. These preliminary efficacy and safety results appear encouraging enough to warrant further follow-up and studies for better determination of the potential clinical utility of etanercept for IMCVDs.

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Documento generato il 16/02/20 alle ore 20:40:47