Tumor necrosis factor-alpha antagonists in patients with complicated spinal tuberculosis: A case series and literature review - 31/08/24
Highlights |
• | Spinal TB is often associated with poor outcomes. |
• | Excessive host inflammation contributes to morbidity in affected patients. |
• | Corticosteroids do not always effectively improve outcome in complicated spinal TB. |
• | TNF-α antagonists result in improvement in most steroid-resistant cases. |
• | Future trials are required to confirm this benefit in complicated spinal TB. |
Abstract |
Introduction |
Spinal tuberculosis is often associated with poor outcomes; host-directed inflammation involving the spine contributes to this disability.
Methods |
A retrospective review of patients with complicated spinal tuberculosis having received tumor necrosis factor-alpha (TNF-α) antagonists at a referral hospital in South Africa. A literature review was performed to identify all published cases of complicated spinal tuberculosis that received a TNF-α antagonist as part of their treatment.
Results |
We describe 23 cases, of which 19 were previously reported in the literature. All patients were treated with either thalidomide (n=6) or infliximab (n=16), except for one who received both. All in all, 21 (91%) cases improved neurologically and, at the end of follow-up, 18 could walk.
Conclusion |
There is accumulating experience to confer the efficacy and safety of TNF-α antagonists in treating complicated spinal tuberculosis cases. Evidence from randomized controlled trials is urgently required to substantiate these findings.
Le texte complet de cet article est disponible en PDF.Keywords : Tuberculosis, Spinal cord, Inflammation, Treatment, Central nervous system
Plan
| 2 | The study was presented as a poster presentation at the Neurological Association of South Africa (NASA) annual congress at Bloemfontein, South Africa, 19 April 2024. |
Vol 54 - N° 6
Article 104941- septembre 2024 Retour au numéro
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