Article
Etanercept (Enbrel): update on therapeutic use
George Spencer-Green
Immunex Corporation,
51 University Street, Seattle, WA 98101, USA
Correspondence to: Dr Spencer-Green (spencerg{at}immunex.com)
Tumour necrosis factor (TNF) is an important inflammatory
disease mediator in a wide spectrum of articular diseases, including adult and juvenile rheumatoid arthritis (RA, JRA). Etanercept (Enbrel),
approved in the United States and in Europe for use in patients with RA
and JRA, is an effective inhibitor of TNF that has been shown to
provide rapid and sustained improvement in both of these diseases. Long
term studies continue to show that etanercept controls signs and
symptoms of RA and JRA with no change in rate or type of adverse event
over time. To demonstrate that etanercept is effective as first line
treatment for patients with early active RA who have not been
previously treated with methotrexate, and to examine the effect of
etanercept on radiographic progression, a double blind, placebo
controlled study was recently conducted, comparing etanercept with
methotrexate (median dose 20 mg per week). Both etanercept 25 mg twice
weekly and rapidly escalated methotrexate were effective in reducing
the signs and symptoms of RA, and etanercept was significantly better
than methotrexate in slowing the rate of radiographic erosions. In
patients with severe psoriatic arthritis (PsA), a double blind, placebo
controlled study demonstrated that etanercept was also effective in
reducing disease activity in PsA. Etanercept has been well tolerated in all of these clinical trials and offers an important new treatment option to patients with inflammatory articular diseases.
© 2000 by Annals of the Rheumatic Diseases
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