Background Etanercept is an efficient treatment of Rheumatoid arthritis (RA), but the effect on extraarticular features remains unknown.
Objectives To evaluate the efficacy of etanercept on extraarticular features of RA.
Methods We looked for tenosynovitis, rheumatoid nodules in 87 patients (70 women,17 men) with RA or juvenile rheumatoid arthritis (JRA), at day 0, before beginning treatment with Etanercept (25 mg twice a week) and at day 180 of treatment. The population included 82 cases of RA and 5 cases of JRA, rheumatoid factor positive in 64 cases, median age 51 years (7‑76). The median duration of RA was 11 years (2‑32) and the median number of previous treatments was 5 (1‑10).
Results The evolution of the median value of modified DAS 28 was highly significant, with a score of 4.0 at day 0 and 1.7 at day 180(p = 0.01). At day 180,72 patients could be assessed for the 3 parameters studied. At day 0,72 patients out of 87 had tenosynovitis. All tenosynovitis disappeared in 12 patients, some but not all tenosynovitis disappeared in 7 patients. New tenosynovitis appeared at day 180 in 8 patients, 45 patients remained unchanged.
Moreover,22 nodules were counted in 10 patients out of 87 assessed at day 0. At day 180, the assessment remained unchanged. Nodules neither appeared nor disappeared. No other extraarticular features appeared during treatment.
Conclusion Etanercept is an effective inhibitor of TNFa providing clinical and biological improvement in both RA and JRA. However, Etanercept had no efficacy on tenosynovitis and rheumatoid nodules.