This article is more than 5 years old. Information may no longer be current.
Etanercept, isoniazid may lead to optic neuritis
Click Here to Manage Email Alerts
Two common drugs for the treatment of rheumatoid arthritis and tuberculosis may cause patients to develop optic neuritis, according to a case study. Discontinuation of the pharmaceuticals should help resolve the neuritis, the study authors said.
Raul Noguera-Pons, MD, and colleagues at the University of Elche in Alicante, Spain, reported a case of optic neuritis associated with concurrent etanercept and isoniazid therapy. The 55-year-old man with rheumatoid arthritis had been treated with numerous pharmaceuticals for its treatment; he had been put on etanercept 4 months before presenting. Three months before presenting, latent tuberculosis was discovered, and he was administered isoniazid 300 mg and pyridoxine 50 mg once daily in conjunction with the etanercept therapy. Treatment with subcutaneous etanercept 25 mg twice weekly was initiated 5 days after the isoniazid.
Two weeks before presentation, the patient complained of blurred vision; 10 days after that his vision worsened. Visual acuity in both eyes was 0.7. After a diagnosis of bilateral optic neuritis was confirmed, the etanercept was stopped; the isoniazid was replaced with rifampin 600 mg once daily.
“The optic neuritis was unlikely to be an early manifestation of multiple sclerosis based on the clinical course and the negative results of the imaging tests,” the authors said. After discontinuing the concurrent therapy, the patient’s general condition improved.
The study is published in the November issue of The Annals of Pharmacotherapy.