Effect of tumor necrosis factor inhibitors on rheumatoid arthritis-induced peripheral neuropathy: A cohort study★

In this historical cohort study, 236 patients with primary rheumatoid arthritis were treated with the tumor necrosis factor inhibitors, etanercept or infliximab (n = 80), or by conventional methods (n = 156). Results revealed that 11 patients developed varying types of peripheral neuropathy at 1–2 years post-treatment (mean 16 months). The incidence of peripheral neuropathy in the tumor necrosis factor inhibitors treatment group was 8.8% (7/80), which was significantly higher than the conventional treatment group (2.6%; 4/156). The relative risk of developing peripheral neuropathy in the tumor necrosis factor inhibitors treatment group was 3.41 (95% confidence interval: 1.03–11.31). Comparison of the tumor necrosis factor inhibitors revealed that etanercept and infliximab had no significant difference in terms of inducing peripheral neuropathy. Experimental findings indicate that tumor necrosis factor inhibitors may increase the risk of peripheral neuropathy.