Neutropenia After the Third Cycle of Etanercept

Febrile neutropenia associated with adalimumab in a patient with ulcerative colitis

“…Another plausible mechanism is the development of antibodies leading to peripheral consumption, 16 as seen in a case where significant neutropenia and anti-drug antibody production occurred upon restarting etanercept for the third time without methotrexate in a rheumatoid arthritis patient. 17 One retrospective cohort study observed that the incidence of severe infections due to neutropenia induced by anti-TNF-α therapy was merely 6%. 18 The notably lower rate of severe and life-threatening infections in anti-TNF αinduced neutropenia compared to other neutropenia causes may indicate a shift of neutrophils from circulation to endothelium adhesion, thereby maintaining availability against infections.…”

“…Neutropenia related to adalimumab has been reported in contexts involving T‐large granular lymphocyte (T‐LGL) expansion, 15 suggesting the potential involvement of T‐LGL proliferation in the pathogenesis of anti‐TNF‐induced neutropenia through interactions like Fac/Fac or by independently suppressing neutrophil precursors. Another plausible mechanism is the development of antibodies leading to peripheral consumption, 16 as seen in a case where significant neutropenia and anti‐drug antibody production occurred upon restarting etanercept for the third time without methotrexate in a rheumatoid arthritis patient 17 …”

“…Another plausible mechanism is the development of antibodies leading to peripheral consumption, 16 as seen in a case where significant neutropenia and anti‐drug antibody production occurred upon restarting etanercept for the third time without methotrexate in a rheumatoid arthritis patient. 17 …”