Neuroinflammatory events after anti-TNF alpha therapy

We have read with interest the article by Kopp et al that has been published recently in the Annals of the Rheumatic Diseases. The article deals with the risk of neuroinflammatory events (NIEs) in patients with inflammatory arthritides (IA), receiving tumour necrosis factor alpha (TNFα) inhibitors.1 Their cases were identified from the nationwide registries of Sweden and Denmark, in a prospective observational study. The authors found an increased risk of NIEs after anti-TNFα therapy in patients with spondyloarthropathies (SpAs) as compared with those not receiving TNF blockers, while no consistent and significant risk of NIEs after anti-TNFα treatment in rheumatoid arthritis (RA) patients. They concluded that the risk profile of NIEs in patients receiving TNFα inhibitors differs among patients with different IA which has an impact on decision-making in clinical practice.\n\nIn a prospective imaging and electrophysiological study of our clinic, patients with RA and SpAs who were eligible for anti-TNFα therapy had been investigated, during the period May 2009 to December 2011.2 Before …