Table 3.
Patient number | Age (years) | Gender | Years followed at NIH | Duration of etanercept (days) | Followed up post-etanercept (year) | Etanercept dose (mg/week) | Use of cysticidal medication(s) with etanercept | Disease type | Reason for etanercept | Medication regimens | Outcome |
---|---|---|---|---|---|---|---|---|---|---|---|
2 | 35 | M | 4.1 | 31 | 0.0 | 50 | Yes | SUBNCC | Failed corticosteroid taper, added immunosuppression and sparing | Corticosteroids + methotrexate to corticosteroids + methotrexate + 50 mg etanercept | Short-term improvement. lost to follow-up at 31 days |
4 | 41 | F | 0.4 | NA | NA | 50 | Yes | Spinal SUBNCC | Failed corticosteroid taper + anakinra, added immunosuppression and corticosteroid sparing | Corticosteroids + anakinra to corticosteroids + 50 mg etanercept + anakinra | Tapered from 29 mg prednisone to 0.5 mg with mild improvement of symptoms due to spinal disease. Continues on etanercept |
6 | 41 | F | 5.0 | 41 | 4.9 | 25 | Yes | SUBNCC | Added immuosuppression, corticosteroid sparing | Corticosteroids + methotrexate + 25 mg etanrecept to corticosteroids | Improved short term but on taper developed neurological symptoms controlled on high-dose corticosteroids alone |
7 | 51 | M | 1.6 | 380 | 0.3 | 50 | Yes | SUBNCC | Corticosteroid replacement for corticosteroid psychosis | 50 mg etanercept | Dramatic clinical improvement |
8 | 57 | M | 0.7 | NA | NA | 50 | Yes | SUBNCC, spinal | Added immunosuppression, corticosteroid replacement, and sparing | Corticosteroids to corticosteroids + 50 etanercept | Still on etanercept, moderate clinical improvement of pain due to spine involvement |
9 | 41 | F | 4.0 | 699 | 2.1 | 25,50 | Yes | SUBNCC, ventricular | Failed corticosteroid taper, added immunosuppression and sparing | Corticosteroids to corticosteroids + methotrexate to corticosteroids + methotrexate + 50 mg etanercept to 50 mg etanercept | Taper successful after the dose of etanercept was increased and did well on etanercept alone |
10 | 30 | M | 3.6 | 272 | 2.6 | 25 | Yes | SUBNCC, calcification | Failed corticosteroid taper, added immunosuppression and sparing | Corticosteroids to corticosteroids + 25 mg etanercept | Taper successful after the dose of etanercept was increased and did well on etanercept alone |
11 | 37 | M | 6.6 | 229 | 5.6 | 25 | Yes | SUBNCC, calcifications | Failed corticosteroid taper + methotrexate, added immunosuppression and sparing | Corticosteroids + methotrexate to 25 mg etanrecept + corticosteroids + methotrexate + 25 mg etanercept to methotrexate + 25 mg etanercept | Taper successful and avoided worsening in avascular necrosis on corticosteroid side effects |
12 | 26 | M | 8.0 | 461 | 5.6 | 25 | Yes | SUBNCC | Failed corticosteroid taper, added immunosuppression and sparing | Corticosteroids to corticosteroids + methotrexate to corticosteroids + methotrexate + 25 mg etanercept + methotrexate to 25 mg etanercept + corticosteroids to 25 mg etanercept | Taper successful and avoided further worsening of avascular necrosis of the hip |
13 | 41 | M | 4.9 | 350 | 3.2 | 25 | Yes | SUBNCC | Added immunosuppression | Corticosteroids to 25 mg etanercept corticosteroids + methotrexate to 25 mg etanercept to methotrexate to methotrexate | Developed large vessel stroke after completing therapy, resulting in retreatment that avoided additional vascular complications |
14 | 28 | M | 6.3 | 356 | 4.6 | 25 | No | Ventricular calcifications | Added immunosuppression and corticosteroid sparing | Corticosteroids to corticosteroids + methotrexate + 25 mg etanercept to corticosteroid + 25 mg etanercept to 25 mg etanercept | Taper successful and on prolonged etanercept with loss of priventricular edema and associated symptoms |
15 | 39 | F | 4.7 | 210 | 3.4 | 25 | No | SUBNCC | Failed corticosteroid taper, added immunosuppression, and replacement | Corticosteroids + methotrexate to 25 mg etanercept + corticosteroids + methotrexate + 25 mg etanercept to methotrexate | Taper successful with improved symptoms and loss of corticosteroid side effects, although improved still has headaches and depression, but no further transient episodes of hemiparalysis |
NIH = National Institutes of Health; SUBNCC = subarachnoid neurocysticercosis.