AB1424 INVESTIGATION OF THE TYPE AND FREQUENCY OF NEUROLOGICAL SIDE EFFECTS WITH BIOLOGICAL TREATMENT IN INFLAMMATORY RHEUMATIC DISEASES

Abstract

Background: With the increasing use of biological treatment in infammatory rheumatic diseases, some neurological side effects, especially central and peripheral nervous system demyelinating disorders, are seen. Objective(s): To evaluate whether there is an increase in the frequency of neurological disorders with biological treatment compared to the normal population, and the relationship between discontinuation of biological agents and neurological symptoms. Method(s): Adult patients using biological treatment followed in the Rheumatology outpatient clinic of Dokuz Eylul University between January 2011 and January 2020 were included. The relationship between biological agents and type, severity and duration of neurological symptoms, and the laboratory, imaging (cranial CT, MRI) and electrophysiological fndings of the patients were retrospectively reviewed. Current treatments for rheumatologic disease and neurological fnd-ings, and disease activity were investigated. Result(s): In our study, neurological side effects were observed in 16 (1.8%) of 877 patients using biological drugs. The mean age of the patients was 51.8+/-12.53 years, and the duration of rheumatologic disease was 10.69+/-4.86 years. Nine patients had peripheral neuropathy, two had CNS demyelinating disease, two had peripheral demyelinating disease, two had intracranial mass and one had headache syndrome. The neurological disease developed a mean of 51.31+/-44.26 months after the frst biological agents. The demographic and clinical characteristics of the patients and the neurological side effects that developed during the follow-up period are summarized in Table 1. Biological treatment was discontinued in 68.8% of patients. There was no signifcant correlation between biological agents' continuation status and progression of neurological fndings. Conclusion(s): In this study, the prevalence of neurological diseases such as brain tumors, multiple sclerosis, and myasthenia gravis increased in patients receiving biological treatment compared to the normal population. Therefore, patients using biological agents should also be questioned and examined in terms of neurological symptoms, and further examination should be applied if necessary. No signifcant relationship was found between discontinuation of biological drugs and improvement/progression of neurological symptoms, and more comprehensive studies are needed.