Title:
Sensorineural hearing loss in ankylosing spondylitis treated with TNF blockers
Authors:
M. Savastano*, G. Marioni*, L. Giacomelli**, R. Ramonda***, S. M. Ferraro*, L. Punzi***
Institutions:
*Department of Medical and Surgical Specialties, Section of Otolaryngology; **Department of Medical/Diagnostic Sciences and Special Therapies, Section of Anatomic Pathology; ***Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy
Keywords:
Anti-TNF; etanercept; infliximab; ankylosing spondylitis; sensorineural hearing loss; spondyloarthritis
Pages:
183 - 188
Abstract:
Sensorineural hearing loss in ankylosing spondylitis treated with TNF blockers. Objectives: Sensorineural hearing loss (SNHL) in the uncommon disease ankylosing spondylitis (AS) has been previously reported. We analysed the relationships between AS, anti-TNF drug treatment, and SNHL. Methodology: We determined pure tone thresholds in 28 consecutive patients with AS who were treated with the TNF inhibitors etanercept or infliximab, or with a TNF inhibitor plus methotrexate (MTX). Results: SNHL was diagnosed in 16 patients (57.1%): 7/7 (100%) of those treated with anti-TNF plus MTX, and 9/21 (43%) of those treated with anti-TNF alone. We found a significant association between SNHL and treatment modality (p = 0.011) or treatment time in months (p = 0.020). Conclusions: The SNHL rate was significantly higher in patients treated with anti-TNF plus MTX than those treated with anti-TNF alone. The culpability of anti-TNF therapy was supported by the association between SNHL and treatment time, which was longer for anti-TNF plus MTX than for anti-TNF alone. SNHL may be due not only to AS, but also to drug-induced vasculitis of the labyrinthine artery or its cochlear branch.
Issue:
Vol. 6, 2010, 3rd trimester


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Sensorineural hearing loss in ankylosing spondylitis treated with TNF blockers