PMID- 11568668
OWN - NLM
STAT- MEDLINE
DCOM- 20011207
LR  - 20220410
IS  - 1531-7129 (Print)
IS  - 1531-7129 (Linking)
VI  - 22
IP  - 5
DP  - 2001 Sep
TI  - Etanercept therapy for immune-mediated cochleovestibular disorders: preliminary 
      results in a pilot study.
PG  - 619-24
AB  - OBJECTIVE: Immune-mediated cochleovestibular disorders (IMCVDs) continue to 
      present a management challenge to the otolaryngologist. Antirheumatic agents, 
      commonly used for IMCVDs, are associated with variable efficacy and sometimes 
      with serious side effects. The authors describe the preliminary result of their 
      experience in patients with IMCVDs who have been treated with etanercept, a tumor 
      necrosis factor alpha receptor blocker, recently approved by the United States 
      Food and Drug Administration for the treatment of rheumatoid arthritis. STUDY 
      DESIGN: Retrospective case series. SETTING: Tertiary care hospital. PATIENTS: 
      Twelve patients suspected of having IMCVD who did not respond to conventional 
      therapies or experienced side effects of the conventional therapies. 
      INTERVENTION: Etanercept 25 mg by subcutaneous injection twice per week. MAIN 
      OUTCOME MEASURES: The main outcome measurement was assessment of hearing change 
      by air conduction pure tone audiograms and/or word discrimination. When present, 
      vertigo, tinnitus, and aural fullness were assessed as well. RESULTS: Follow-up 
      of more than 5 months was available for all patients (range, 5-12 months). Eleven 
      (92%) of 12 patients had improvement or stabilization of hearing and tinnitus, 
      seven (88%) of eight patients who had vertigo and eight (89%) of nine patients 
      who had aural fullness had resolution or significant improvement of their 
      symptoms. The benefit persisted until the last visit (5-12 months after 
      etanercept was begun). The condition of one patient improved dramatically at 
      first but deteriorated after 5 months. The patient's hearing was rescued and 
      stabilized with the addition of leflunomide to etanercept. Similarly, three other 
      patients required a second antirheumatic agent to stabilize their hearing. There 
      were no significant side effects from the etanercept therapy. CONCLUSIONS: Our 
      limited data suggest that etanercept therapy is safe and may be efficacious in 
      carefully selected patients with IMCVDs, at least on a short-term basis. These 
      preliminary efficacy and safety results appear encouraging enough to warrant 
      further follow-up and studies for better determination of the potential clinical 
      utility of etanercept for IMCVDs.
FAU - Rahman, M U
AU  - Rahman MU
AD  - Rheumatology Unit, Department of Medicine, Massachusetts General Hospital, 
      Boston, Massachusetts 02114, USA.
FAU - Poe, D S
AU  - Poe DS
FAU - Choi, H K
AU  - Choi HK
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Otol Neurotol
JT  - Otology & neurotology : official publication of the American Otological Society, 
      American Neurotology Society [and] European Academy of Otology and Neurotology
JID - 100961504
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Isoxazoles)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - G162GK9U4W (Leflunomide)
RN  - OP401G7OJC (Etanercept)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antirheumatic Agents/*therapeutic use
MH  - Cochlear Diseases/complications/*immunology/*therapy
MH  - Etanercept
MH  - Female
MH  - Follow-Up Studies
MH  - Hearing Loss, Sensorineural/diagnosis/etiology
MH  - Humans
MH  - Immunoglobulin G/*therapeutic use
MH  - Isoxazoles/therapeutic use
MH  - Leflunomide
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Receptors, Tumor Necrosis Factor/*therapeutic use
MH  - Retrospective Studies
MH  - Tinnitus/diagnosis/etiology
MH  - Vertigo/diagnosis/etiology
MH  - Vestibular Diseases/complications/*immunology/*therapy
EDAT- 2001/09/25 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/09/25 10:00
PHST- 2001/09/25 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/09/25 10:00 [entrez]
AID - 10.1097/00129492-200109000-00010 [doi]
PST - ppublish
SO  - Otol Neurotol. 2001 Sep;22(5):619-24. doi: 10.1097/00129492-200109000-00010.