New onset heart failure in adolescents with inflammatory joint disease treated with TNF-α inhibitors: a case-based review.

IF 3.2 3区医学 Q2 RHEUMATOLOGY

Rheumatology International Pub Date : 2024-12-18 DOI:10.1007/s00296-024-05750-x

Sophie Mavrogeni, Evdoxia Sapountzi, Kyveli Chiotopoulou, Lampros Fotis

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Abstract

The safety of tumor necrosis factor (TNF) inhibitors has been demonstrated for over two decades. However, their effects on cardiovascular function in patients with rheumatic diseases remain controversial, and conclusions are additionally hampered by the cardiovascular complications inherent in such diseases. We present two 15-year-old patients diagnosed with ankylosing spondylitis and juvenile idiopathic arthritis classified as polyarthritis with positive rheumatoid factor, respectively. Soon after treatment onset with adalimumab and etanercept, respectively, they developed myocardial inflammation leading to heart failure. Their condition improved upon treatment discontinuation and onset of secukinumab and tocilizumab, respectively. A thorough literature search revealed that these are the only cases of heart failure reported to date after anti-TNF treatment in adolescents with rheumatic diseases. Although cardiovascular adverse effects seem to be very rare in this population, even atypical symptoms of cardiac failure should not be ignored, and cardiac function should be closely monitored when administering anti-TNF-α.

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来源期刊

Rheumatology International 医学-风湿病学

CiteScore

7.30

自引率

5.00%

发文量

191

审稿时长

16. months

期刊介绍： RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.