Key result
Adalimumab-treated rheumatoid arthritis is linked to cardiac tamponade despite well-controlled joint disease.
Why the study?
TNF-inhibitor therapy is effective for articular rheumatoid arthritis but may be less effective for extra-articular disease, including life-threatening cardiac complications.
Case Report (n=2)
TNF-inhibitors may not effectively control extra-articular manifestations of rheumatoid arthritis, such as pericardial effusion and cardiac tamponade, even when joint disease is quiescent.
May signal tamponade risk in adalimumab-treated RA despite quiescent joints; case report leaves open TNF-inhibitor control of extra-articular disease.
Tumour necrosis factor-inhibitor (TNF-inhibitor) therapy is increasingly used for the treatment of rheumatoid arthritis. While it is effective for the articular manifestations of rheumatoid arthritis we have reason to believe that it is less effective for extra-articular disease. We present two cases of life-threatening cardiac tamponade in two patients with well-controlled rheumatoid arthritis on adalimumab. An extensive literature search was carried out and three other patients were found. We believe that these cases highlight the need for rheumatologists to be vigilant for extra-articular manifestations of rheumatoid arthritis even in the presence of quiescent joint disease while on TNF-inhibitors.
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Soh et al. (2009) conducted a case report in Rheumatoid arthritis (n=2). Adalimumab (TNF-inhibitor) was evaluated on Life-threatening cardiac tamponade. Two patients with well-controlled rheumatoid arthritis on adalimumab developed life-threatening cardiac tamponade, highlighting the risk of extra-articular manifestations despite quiescent joint disease.
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