title: Use of etanercept in the treatment of dermatomyositis: a case series.
abstract: OBJECTIVE
  To evaluate the efficacy of etanercept, a recombinant human soluble fusion protein of tumor necrosis factor-alpha (TNF-alpha) type II receptor and IgG1, in patients with adult dermatomyositis (DM).
  
  
  METHODS
  Five patients with active DM were studied. All patients reported muscle weakness and had elevated muscle enzymes creatine kinase and lactate dehydrogenase. Because of lack of response to steroid and cytotoxic therapy, etanercept was given at a dose of 25 mg subcutaneously twice a week for at least 3 months.
  
  
  RESULTS
  All patients experienced an exacerbation of disease, with increase of muscle weakness, elevation of muscle enzyme levels, and unchanged rash. Treatment with etanercept was stopped. After receiving a combination of methotrexate (MTX) and azathioprine, disease manifestations improved in all patients.
  
  
  CONCLUSIONS
  In our case series, TNF-alpha inhibition by etanercept was not effective, suggesting that a broad immunosuppressive therapy is needed to treat DM.
authors.affiliation: Rheumatology Unit, Department of Internal Medicine and Public Health, University of Bari, Bari, Italy.
authors.forename: Florenzo
authors.initials: F
authors.lastname: Iannone
authors.forename: Crescenzio
authors.initials: C
authors.lastname: Scioscia
authors.forename: Paola C F
authors.initials: PC
authors.lastname: Falappone
authors.forename: Michele
authors.initials: M
authors.lastname: Covelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lapadula
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D003882:Dermatomyositis / Q000150:complications / Q000188:drug therapy*; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology / Q000517:prevention & control*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept