digoxin and Spondylitis--Ankylosing

A 42-year-old man with ankylosing spondylitis that was refractory to nonsteroidal anti-inflammatory drugs as well as various disease-modifying antirheumatic drugs was subjected to anti-TNF compounds. Administration of infliximab and adalimumab gave excellent clinical response but was discontinued due to adverse events. Introduction of etanercept was also clinically effective but followed by development of severe heart failure. Discontinuation of etanercept led to control of heart function. The unusually though potentially life-threatening possibility of heart failure secondary to anti-TNF use in ankylosing spondylitis merits attention.

Topics: Adult; Anti-Arrhythmia Agents; Digoxin; Diuretics; Etanercept; Heart Failure; Humans; Immunoglobulin G; Immunologic Factors; Male; Receptors, Tumor Necrosis Factor; Spondylitis, Ankylosing