Etanercept for psoriasis and psoriatic arthritis in a patient with Charcot-Marie-Tooth disease

INTRODUCTION & OBJECTIVES: The therapeutic management of psoriasis and other diseases has been much improved by the use of biologic agents, which have brought a significant amelioration of the patients’ quality of life. Unfortunately, the use of some of these agents has been associated, either directly or indirectly, with neurological complications. In particular, several cases of central and peripheral demyelinating events have emerged, prompting a heightened surveillance of treated patients. Under this aspect, the involvement of the peripheral nervous system appears to be rare if compared to the demyelinating disorders of the central nervous system. However, according to the recent literature, the incidence of such events is relatively low and the influence of anti-TNF-alpha agents on the course of neuropathy is variable, suggesting that treatment withdrawal is not always necessary for neuropathy control. MATERIAL & METHODS: The Charcot-Marie-Tooth disease (CMT) is the most common inherited neuromuscular disorder and is characterized clinically by distal wasting, weakness and sensory loss. The main subtype is the demyelinating type 1A, representing about half of all CMT cases. The authors report a case of a 49-year-old woman affected by CMT1A and psoriasis with psoriatic arthritis, successfully treated with etanercept without any detrimental effect on the neurological disease.