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Abstract Number: 1095

Tolerance of non-TNF α treatments in patient with an inflammatory rheumatic (IRD) and autoimmune demyelinating diseases: French retrospective cases series

dellal azeddine1, Jean-Guillaume Letarouilly2, Jacques Morel3, René-Marc Flipo4, Valerie Devauchelle5, richette pascal6, Philippe Dieude7, Hubert Marotte8, FELTEN Renaud9, LATOURTE Augustin10, CHEVET Baptiste11, HILLIQUIN Pascal12, SORDET Christelle9, DERNIS mmanuelle13, WENDLING Daniel14, Arsène Mekinian15, Nathalie BALLANDRAUD16, Christophe Richez17, TOURNADRE Anne18, salmon Jean -Hugues19, SAILLOT Carine20, kedra joanna21, nahon stephane22, LE GOFF Benoit23, Bruno Fautrel24, Francis BERENBAUM25, David SAADOUN26, PHAM Thao16 and SELLAM JEREMIE27, 1GHI LE RAINCY MONTFERMEIL, Montfermeil, France, 2Université de Lille, CHU Lille, Service de rhumatologie, Lille, France, LILLE, Nord-Pas-de-Calais, France, 3CHU and University of Montpellier, Montpellier, France, 4Université de Lille, CHU Lille, Service de rhumatologie, Lille, France, Lille, France, 5UBO, Brest, France, 6Rheumatology Department, Lariboisiere Hospital, Paris, Ile-de-France, France, 7Service de Rhumatologie, Hôpital Bichat APHP, Paris, Paris, Ile-de-France, France, 8INSERM 1059/University of Saint-Etienne, Saint-Etienne, France, 9Service de Rhumatologie, Centre de référence des maladies auto-immunes rares (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, Strasbourg, Alsace, France, 10Rheumatology Department, Lariboisiere Hospital, Paris, France, 11CHU BREST, brest, Bretagne, France, 12CH SUD FRANCILIEN, PARIS, France, 13chu caen, CAEN, Haute-Normandie, France, 14CHU de Besançon, Besançon, Franche-Comte, France, 15Department of Internal Medicine, Inflammation-Immunopathology-Biotherapy Department (DMU i3), Saint-Antoine University Hospital, 75012 Paris, France, Paris, France, 16CHU MARSEILLE, marseille, Provence-Alpes-Cote d'Azur, France, 17Bordeaux University Hospital, Bordeaux, France, 18CHU CLERMONT, CLERMONT, Lorraine, France, 19CHU REIMS, REIMS, Champagne-Ardenne, France, 20CHU ORLEANS, ORLEANS, Pays de la Loire, France, 21Pitié-Salpêtrière Hospital, Rheumatology Department, APHP, Sorbonne University,, Paris, France, 22GHI LE RAINCY MONTFERMEIL, Montfermeil, Ile-de-France, France, 23CHU Nantes, Nantes, France, 24Sorbonne Université - APHP, Department of Rheumatology, Hôpital Pitié-Salpêtrière, Inserm UMRS 1136-5, PARIS, France, Paris, France, 25Sorbonne University/Inserm/AP-HP/4Moving Biotech, Paris, France, 26CHU LA PITIE SALPETRIERE, PARIS, Ile-de-France, France, 27Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, F-75012 Paris, France, /Rheumatology Department, AP-HP Saint-Antoine Hospital, 184, rue du Faubourg Saint-Antoine, 75012, Paris, France., Paris, France

Meeting: ACR Convergence 2025

Keywords: Anti-TNF Drugs, Biologicals, neurology, Psoriatic arthritis, rheumatoid arthritis

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Session Information

Date: Monday, October 27, 2025

Title: (1088–1122) Immunological Complications of Medical Therapy Poster

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: The use of TNFα antagonist is not recommended if the patient have a suspicion or demyelinating diseases (DD) confirmed [1]. There are a few cases reported that non-TNFi targeted are used in this situation [2-3].To establish the evolution of DD (stability, aggravation) in patients with a rheumatic disease receiving biological non TNFαi or synthetic therapies, in a retrospective French cohort study.

Methods: A retrospective French multicenter descriptive, national study. Reported cases followed notifications via the CRI (Club Rhumatisme Inflammatoire) newsletter.Inclusion criteria: Patients > 18 years of age, with IRD (rheumatoid arthritis [RA], spondyloarthritis [SpPA], psoriatic arthritis [psoriatic arthritis]), treated with a non TNFi targeted therapy for more than 3 months, and presenting with demyelinating disease (MS and/or neurological manifestations suggestive of demyelinating disease), whether or not they occurred while on TNFi therapy.

Results: 51 patients received at least one non-TNF targeted therapy (33 SpA, 13 RA, 5 R Pso), with clinical, biological and therapeutic characteristics at Baseline. The mean age of diagnosis of demyelinating pathology was 37.8 years (12-76) in the SpA group, 42.7 (24-58) in the RA group and 45.8 (32-56) in the R Pso group.51% (n=26) had at least one prior exposure to an anti-TNF before the onset of demyelinating pathology (21 SPA, 1 Rpso, 4 PR). Exposure to non-TNF treatments in the different therapeutic lines is: 40 patients to anti-IL17 with a mean duration of 25 months (2-103), 5 patients to Anti-IL6R with a mean duration of 42.2 months (21-133), 9 patients to CTLA-4Ig (Abatacept) with a mean duration of 18.6 months (3 -64), 7 patients to Jaki with a mean duration of 19.3 months (2-38), 2 patients to anti-IL23 with a mean duration of 8.5 (7-10), 12 patients to anti-CD20 with a mean duration of 18.1 months (4-118), 1 patient to apremilast (phosphodiesterase 4 (PDE4) inhibitor) with a mean duration of 29 months and 3 patients to anti-IL-12 and IL-23 with a mean duration of 31.5(14-64).100% of patients (n=51) had stability or improvement of demyelinating pathology.The combination in 6 patients treated with secukinumab, 1 patient with tocizulumab, and 1 patient with rituximab with a background MS treatment (interferon beta, teriflunomide, ocrelizumab, glatiramer acetate) was well tolerated.

Conclusion: The use of non-anti-TNF targeted therapies (anti-IL17, anti-IL6R, CTLA-4Ig, Jaki, anti-IL23, anti-CD20, PDE4 inhibitor, and anti-IL-12 and IL-23) in patients with RIC does not appear to worsen demyelinating disease.


Disclosures: d. azeddine: None; J. Letarouilly: AbbVie/Abbott, 6, Amgen, 6, Biogen, 6, Bristol-Myers Squibb(BMS), 6, Eli Lilly, 6, Galapagos, 6, Janssen, 6, Nordic Pharma, 6, Novartis, 6, Pfizer, 6; J. Morel: AbbVie, 2, 5, 6, Biocon, 6, Biogen, 6, Boehringer Ingelheim, 2, Bristol Myers Squibb, 2, 5, 6, Fresenius Kabi, 2, 6, Galapagos, 2, 6, GlaxoSmithKline, 2, 6, Lilly, 2, 6, Medac, 6, Mylan/Viatris, 6, Nordic Pharma, 6, Novartis, 2, 5, 6, Pfizer, 5, 6, Roche/Chugai, 6, Sanofi, 2, 6; R. Flipo: AbbVie/Abbott, 6, Amgen, 6, Boehringer-Ingelheim, 6, Janssen, 6, Medac, 6, Novartis, 6, Pfizer, 6; V. Devauchelle: None; r. pascal: None; P. Dieude: None; H. Marotte: None; F. Renaud: None; L. Augustin: None; C. Baptiste: None; H. Pascal: None; S. Christelle: None; D. mmanuelle: None; W. Daniel: None; A. Mekinian: Roche, 5; N. BALLANDRAUD: None; C. Richez: None; T. Anne: None; s. Jean -Hugues: None; S. Carine: None; k. joanna: None; n. stephane: None; L. Benoit: AbbVie/Abbott, 1, Amgen, 1, Bristol-Myers Squibb(BMS), 1, 5, Fresenius-Kabi, 1, Lilly, 1, Merck/MSD, 1, Novartis, 1, Pfizer, 1, 5, Roche, 1, 5, Sandoz, 5, Viatris, 1; B. Fautrel: AbbVie, 2, 5, Amgen, 2, Biogen, 2, BMS, 2, Celltrion, 2, Chugai, 2, Eli Lilly & Co., 2, 5, Fresenius Kabi, 2, Galapagos, 2, Janssen, 2, Medac, 2, MSD, 2, 5, Nordic Pharma, 2, Novartis, 2, OW KIN, 2, Pfizer, 2, 5, Roche, 2, Sandoz, 2, Sanofi-Genzyme, 2, SOBI, 2, UCB, 2, Viatris, 2; F. BERENBAUM: 4Moving Biotech, 2, 8, 10; D. SAADOUN: None; P. Thao: None; S. JEREMIE: None.

To cite this abstract in AMA style:

azeddine d, Letarouilly J, Morel J, Flipo R, Devauchelle V, pascal r, Dieude P, Marotte H, Renaud F, Augustin L, Baptiste C, Pascal H, Christelle S, mmanuelle D, Daniel W, Mekinian A, BALLANDRAUD N, Richez C, Anne T, Jean -Hugues s, Carine S, joanna k, stephane n, Benoit L, Fautrel B, BERENBAUM F, SAADOUN D, Thao P, JEREMIE S. Tolerance of non-TNF α treatments in patient with an inflammatory rheumatic (IRD) and autoimmune demyelinating diseases: French retrospective cases series [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/tolerance-of-non-tnf-%ce%b1-treatments-in-patient-with-an-inflammatory-rheumatic-ird-and-autoimmune-demyelinating-diseases-french-retrospective-cases-series/. Accessed .
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