Title
Etanercept to control inflammation in the treatment of complicated neurocysticercosis
Date Issued
01 January 2019
Access level
open access
Resource Type
journal article
Author(s)
National Institutes of Allergy and Infectious Diseases
Publisher(s)
American Society of Tropical Medicine and Hygiene
Abstract
Manifestations of neurocysticercosis (NCC) are primarily due to host inflammatory responses directed at drug-damaged or naturally degenerating metacestodes (cysts) of the tapeworm Taenia solium. Prolonged high-dose corticosteroids are frequently required to control this inflammation in complicated disease, often causing severe side effects. Studies evaluating alternatives to corticosteroids are lacking. Here, we describe the clinical course of NCC in 16 patients prescribed etanercept (ETN), a tumor necrosis factor-alpha inhibitor to control inflammation resulting from anthelmintic treatment. Twelve patients with extraparenchymal NCC were administered ETN with corticosteroids (11/12, 91.7%) and/or methotrexate (9/12, 75.0%). The median age of the subgroup with extraparenchymal NCC was 40 years (range 26–57 years) and 66.7% were male. They were administered ETN for a median period of 311 days (range 31–461 days) and then followed for a median of 3.4 years (range 0.3–6.6 years). Among nine assessable patients, all improved clinically after starting ETN and one deteriorated transiently. Of the remaining three, one was lost to follow-up and two patients have improved but had not completed their assigned course. Four additional persons with recurrent perilesional edema (PE) episodes were given ETN for a median of 400.5 days (range 366–854 days) and followed post-ETN for a median of 1.7 years (range 0.2–2.4 years). All PE patients improved and two successfully tapered corticosteroids. Etanercept administration was associated with clinical improvement, stable disease, absence of recurrence, and lack of serious side effects. Etanercept appears to contribute to the control of inflammation and facilitate corticosteroid taper.
Start page
609
End page
616
Volume
100
Issue
3
Language
English
OCDE Knowledge area
Medicina tropical
Parasitología
Scopus EID
2-s2.0-85062596495
PubMed ID
Source
American Journal of Tropical Medicine and Hygiene
ISSN of the container
00029637
Sponsor(s)
Financial support: This work was supported by Intramural National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
Sources of information:
Directorio de Producción Científica
Scopus