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Enbrel

In a small number of cases, certain arthritis drugs have been associated with serious nervous system problems, according to a recent report from researchers at the US Food and Drug Administration (FDA) and elsewhere in Washington, DC.

They recommend that patients receiving Enbrel (etanercept) or Remicade (infliximab) be monitored by their physicians for neurologic symptoms such as confusion, numbness, changes in vision and difficulty walking.

These symptoms are suggestive of demyelination, or the loss of myelin, the fatty sheath that coats nerve fibers and helps nerves function. A familiar example of a demyelinating disease is multiple sclerosis, in which degeneration of nerve cells results in symptoms ranging from numbness and muscle weakness to paralysis.

If neurologic symptoms appear in a patient taking Enbrel or Remicade, the drug should be discontinued immediately, the researchers advise in a recent issue of Arthritis & Rheumatism. The patient should be referred to a neurologist for a thorough examination, they say.

In interviews with Reuters Health, spokespeople for Enbrel's maker Immunex, and Centocor, the maker of Remicade, emphasized that demyelinating disease is a rare complication of therapy with these two drugs. The companies have known about this complication for over a year, and a warning about it appears on their drug packaging and Web sites.

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