{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:20:07Z","timestamp":1789194007162,"version":"build-2803163510"},"reference-count":13,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal - Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> An association between tumour necrosis factor alpha (TNF-\u03b1) inhibitors exposure and central nervous system (CNS) demyelinating disorders has been postulated but is poorly understood. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p> Describe the clinical spectrum and progress of a cohort of patients who developed demyelinating disorder following exposure to TNF-\u03b1 inhibitor. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Retrospective chart review of patients who presented to a single neurologist in Western Australia between May 2003 and July 2020. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> 7 patients (6 females and 1 male) were identified. Mean age was 49.1 years. Mean follow-up time was 2.9 years. Mean interval between commencement of TNF-\u03b1 inhibitor and onset of demyelinating event was 3 years. The spectrum of demyelinating events included transverse myelitis ( N\u2009=\u20093), acute brainstem syndrome ( N\u2009=\u20091) and optic neuritis ( N\u2009=\u20091). 2 patients had an atypical presentation but had MRI findings which unequivocally showed demyelinating changes. 2 patients had a monophasic event while the other 5 patients were diagnosed to have multiple sclerosis. All symptomatic patients with multiple sclerosis were started on disease modifying therapy and remained relapse free during follow-up. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Exposure to TNF-\u03b1 inhibitor appears to increase the risk of demyelinating event. Whether TNF\u03b1 inhibition directly results in CNS demyelination or trigger demyelination in susceptible individuals requires further research. <\/jats:p><\/jats:sec>","DOI":"10.1177\/20552173211070750","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T15:13:43Z","timestamp":1641395623000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Central Nervous System Demyelination Related to Tumour Necrosis Factor Alpha Inhibitor"],"prefix":"10.1177","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2192-0941","authenticated-orcid":false,"given":"Shin Yee","family":"Chey","sequence":"first","affiliation":[{"name":"Department of Neurology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia"},{"name":"Perron Institute for Neurological and Translational Sciences, Perth, Australia"},{"name":"Department of Neurology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia"},{"name":"Perron Institute for Neurological and Translational Sciences, Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4476-4016","authenticated-orcid":false,"given":"Allan G.","family":"Kermode","sequence":"additional","affiliation":[{"name":"Perron Institute for Neurological and Translational Sciences, Perth, Australia"},{"name":"Department of Neurology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia"},{"name":"Perron Institute for Neurological and Translational Sciences, Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"bibr1-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200112)44:12<2862::AID-ART474>3.0.CO;2-W"},{"key":"bibr2-20552173211070750","first-page":"714","volume":"19","author":"Andreadou E","year":"2012","journal-title":"Eur J Neurol"},{"key":"bibr3-20552173211070750","doi-asserted-by":"crossref","DOI":"10.1007\/s11910-017-0742-1","volume":"17","author":"Kemanetzoglou E","year":"2017","journal-title":"Curr Neurol Neurosci Rep"},{"key":"bibr4-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.3.457"},{"key":"bibr5-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1162"},{"key":"bibr6-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.009589"},{"key":"bibr7-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh483"},{"key":"bibr8-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-017-3675-8"},{"key":"bibr9-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.085290"},{"key":"bibr10-20552173211070750","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.120201"},{"key":"bibr11-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043335"},{"key":"bibr12-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.73"},{"key":"bibr13-20552173211070750","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000280576.73609.c6"}],"container-title":["Multiple Sclerosis Journal - Experimental, Translational and Clinical"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20552173211070750","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20552173211070750","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20552173211070750","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T09:35:19Z","timestamp":1740821719000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20552173211070750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1177\/20552173211070750"],"URL":"https:\/\/doi.org\/10.1177\/20552173211070750","relation":{},"ISSN":["2055-2173","2055-2173"],"issn-type":[{"value":"2055-2173","type":"print"},{"value":"2055-2173","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"article-number":"20552173211070750"}}