title: Evaluating the tolerability and efficacy of etanercept compared to triamcinolone acetonide for the intralesional treatment of keloids.
abstract: BACKGROUND
  Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory and profibrotic cytokine that inhibits degradation of collagen and glycosaminoglycans. Etanercept, a recombinant TNF-alpha receptor fusion protein, may decrease excessive fibrous tissue in keloids.
  
  
  OBJECTIVE
  To evaluate the tolerability and efficacy of etanercept as compared to triamcinolone acetonide (TAC) for the treatment of keloids.
  
  
  METHODS
  Twenty subjects were randomly assigned to receive monthly intralesional injections of either 25 mg of etanercept or 20 mg of TAC for 2 months. Keloids were evaluated at baseline, week 4, and week 8 by subjects and investigators in a blinded fashion using physical, clinical, and cosmetic parameters. Photographs were taken and adverse events were noted during each evaluation.
  
  
  RESULTS
  Etanercept improved 5/12 parameters including significant pruritus reduction, while TAC improved 11/12 parameters at week 8, although no statistical difference was observed as compared to baseline. There was no significant difference between the 2 treatment groups. Both treatments were safe and well tolerated.
  
  
  CONCLUSIONS
  Etanercept was safe, well tolerated, improved several keloid parameters, and reduced pruritus to a greater degree than TAC therapy. However, further studies are required before it can be recommended for the treatment of keloids.
authors: University of Miami, Miller School of Medicine, Department of Dermatology and Cutaneous Surgery, Miami, FL 33136, USA. bberman@med.miami.edu
authors: Brian
authors: B
authors: Berman
authors: Jitendrakumar K
authors: JK
authors: Patel
authors: Oliver A
authors: OA
authors: Perez
authors: Martha H
authors: MH
authors: Viera
authors: Sadegh
authors: S
authors: Amini
authors: Samantha
authors: S
authors: Block
authors: Deborah
authors: D
authors: Zell
authors: Sujatha
authors: S
authors: Tadicherla
authors: Adriana
authors: A
authors: Villa
authors: Claudia
authors: C
authors: Ramirez
authors: Tami
authors: T
authors: De Araujo
mesh_terms: D000153:Acne Keloid / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007267:Injections; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D012867:Skin / Q000473:pathology; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014222:Triamcinolone Acetonide; D000068800:Etanercept