A CONCERNING increase in the incidence of central nervous system (CNS) demyelination among patients undergoing biologic treatments for rheumatologic diseases has been revealed by a new study. The retrospective cohort study, conducted by Doruk Arslan et al., assessed over 4,800 patients and reported seven cases of CNS demyelinating disease over 19,391 patient-years.
Among the patients studied, four were diagnosed with multiple sclerosis (MS), and six out of the seven cases occurred in those treated with anti-TNF therapies. The study highlights an annual incidence rate of CNS demyelinating disease at 36.1 per 100,000 patients, with multiple sclerosis alone reaching 19.6 per 100,000. These rates suggest a higher-than-expected incidence compared to European data on MS in the general population.
The findings emphasize the need for heightened vigilance among healthcare professionals when treating patients with biologic agents for rheumatic diseases. Clinicians should be aware of potential neurological signs and symptoms that could signal CNS demyelination. As the study suggests, while biologic therapies can provide effective management of autoimmune conditions, the risk of demyelinating events warrants close monitoring.
This study underscores the evolving understanding of biologic therapies’ long-term effects and serves as a call to action for more research into the neurological risks associated with these treatments.
Reference:
Arslan D et al. Central nervous system demyelination associated with biological agents used in the treatment of rheumatologic diseases: a retrospective cohort study. Neurol Sci. 2025. doi: 10.1007/s10072-025-08354-w.
