PMID- 15934127
OWN - NLM
STAT- MEDLINE
DCOM- 20050816
LR  - 20220410
IS  - 0004-3591 (Print)
IS  - 0004-3591 (Linking)
VI  - 53
IP  - 3
DP  - 2005 Jun 15
TI  - Etanercept therapy for immune-mediated cochleovestibular disorders: a 
      multi-center, open-label, pilot study.
PG  - 337-42
AB  - OBJECTIVE: Immune-mediated cochleovestibular disorders (IMCVDs) continue to 
      present a diagnostic and therapeutic challenge. Antirheumatic agents, commonly 
      employed for IMCVDs, are associated with variable efficacy and sometimes with 
      serious side effects. The objective of the current study was to preliminarily 
      evaluate the efficacy of etanercept therapy for IMCVD. METHODS: In this 
      open-label prospective pilot study, 23 patients with bilateral IMCVDs or symptoms 
      of bilateral Meniere's disease were treated with etanercept (25 mg twice weekly, 
      by subcutaneous injection) for 24 weeks. All participants showed progressive 
      hearing loss within 3 months prior to the study and responded to prednisone 
      therapy. Hearing improvement was defined as an improvement of sensorineural 
      hearing from baseline, in at least one ear, of 15 dB or more in the pure-tone air 
      conduction thresholds, or an increase of more than 12% in word identification 
      score. When present, vertigo and tinnitus were assessed by frequency and severity 
      of attack and a functional level scale. Limited serial positron emission 
      tomography (PET) of the inner ear region was performed in 5 patients to assess 
      disease activity. RESULTS: There were 12 female (52%) and 11 male patients with a 
      mean age of 48 years. Hearing improved in 7 (30%) patients, was unchanged in 13 
      (57%), and worsened in 3 (13%). Of 21 patients with tinnitus, this symptom 
      improved in 7 (33%), was unchanged in 10 (48%), and worsened in 3 (13%). Of 16 
      patients with vertigo, 8 (50%) were improved, 7 (47%) unchanged, and 1 (3%) worse 
      at the end of the study. Etanercept was generally well tolerated. PET was 
      positive on one ear of 2 of 5 patients, remained positive with treatment on 1 of 
      these, and was initially positive in 1 deaf ear, becoming negative at followup. 
      CONCLUSION: These prospective pilot data suggest that etanercept therapy is safe 
      among patients with IMCVDs. However, these data do not suggest substantial 
      efficacy of etanercept among patients with IMCVDs in improving hearing loss. 
      There appeared to be stabilization or improvement of hearing in 87% in this group 
      of patients with pretreatment intractable progressive hearing loss. However, the 
      study endpoint of improvement in 70% of patients was not attained. This 
      short-term effect of possible stabilization requires further study. PET scanning 
      was not useful as a tool to evaluate hearing loss in a limited subset of 
      patients.
FAU - Matteson, Eric L
AU  - Matteson EL
AD  - Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. 
      matteson.eric@mayo.edu
FAU - Choi, Hyon K
AU  - Choi HK
FAU - Poe, Dennis S
AU  - Poe DS
FAU - Wise, Christopher
AU  - Wise C
FAU - Lowe, Val J
AU  - Lowe VJ
FAU - McDonald, Thomas J
AU  - McDonald TJ
FAU - Rahman, Mahboob U
AU  - Rahman MU
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - OP401G7OJC (Etanercept)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Autoimmune Diseases/*drug therapy
MH  - Etanercept
MH  - Female
MH  - Hearing Loss, Sensorineural/drug therapy
MH  - Humans
MH  - Immunoglobulin G/*therapeutic use
MH  - Labyrinth Diseases/*drug therapy/physiopathology
MH  - Male
MH  - Meniere Disease/drug therapy
MH  - Middle Aged
MH  - Pilot Projects
MH  - Positron-Emission Tomography
MH  - Prospective Studies
MH  - Receptors, Tumor Necrosis Factor/*therapeutic use
MH  - Treatment Outcome
EDAT- 2005/06/04 09:00
MHDA- 2005/08/17 09:00
CRDT- 2005/06/04 09:00
PHST- 2005/06/04 09:00 [pubmed]
PHST- 2005/08/17 09:00 [medline]
PHST- 2005/06/04 09:00 [entrez]
AID - 10.1002/art.21179 [doi]
PST - ppublish
SO  - Arthritis Rheum. 2005 Jun 15;53(3):337-42. doi: 10.1002/art.21179.