The effectiveness of
etanercept [tumour
necrosis factor-alpha (
TNFalpha) blocker] and
corticoids in treating immuno-mediated
inner ear disease (IMIED) was compared in an animal model of autoimmune
labyrinthitis. IMIED is one of the few forms of
sensorineural hearing loss that is reversible with proper medical treatment. While the effectiveness and usefulness of
immunomodulating agents (
corticosteroids) in treating IMIED have been demonstrated,
TNFalpha antagonists, which inhibit
granuloma formation in
rheumatoid arthritis and other
autoimmune diseases, have been considered as an alternative
therapy. The efficacy of
etanercept (anti-
TNFalpha) was evaluated in a guinea pig model of experimental autoimmune
labyrinthitis in which 25 guinea pigs were divided in a control group, which was used to document the rise in hearing thresholds following immunisation, and two experimental groups, which were treated with
steroids (6-methylprednisolone) and anti-
TNFalpha (
etanercept), respectively, after the immunisation. Comparison of the auditory thresholds obtained by means of auditory brainstem response (ABR) revealed that the auditory thresholds of the two experimental groups were not statistically different (
6-methylprednisolone: 41.5 dB, SD: 8.51;
etanercept: 37.5 dB, SD: 7.91) and that both compared favourably with that of the control group (60 dB, SD: 7.91) at p=0.001. We therefore conclude that
etanercept is as effective as
glucocorticoids in an animal model of autoimmune
labyrinthitis; however, the potential adverse effects and high price of the former advise against its use as an initial
therapy for IMIED.