title: Update on the use of etanercept across a spectrum of rheumatoid disorders.
abstract: Etanercept is a soluble TNF receptor p75 fusion protein which is approved for subcutaneous use (50 mg weekly) in the treatment of patients with active rheumatoid arthritis (RA), juvenile RA, ankylosing spondylitis, and psoriatic arthritis. Etanercept binds to both TNFalpha and lymphotoxin and has quite a short mean half-life (70 hours). Numerous randomized clinical trials have demonstrated its efficacy to improve signs and symptoms in early and established RA and other inflammatory arthritis. Furthermore, etanercept has shown its ability to prevent radiographic progression and to improve health-related quality of life in patients with RA and psoriatic arthritis. A combination of etanercept plus methotrexate was more efficacious than etanercept monotherapy in RA patients but there is currently no evidence that such rheumatic combination is better than monotherapy in other disorders. Etanercept was generally well tolerated both in controlled trials with withdrawal rates being similar to the comparator groups and in large observational studies. Infections and injection-site reactions were the most frequently reported events. Serious infections were slightly increased but the occurrence of tuberculosis seemed less frequent than with anti-TNF monoclonal antibodies (infliximab and adalimumab). The benefit-risk ratio of etanercept appeared to be very positive, and this drug has now emerged as a major therapy in patients with active inflammatory arthritis. Furthermore, it is more frequently considered as an emerging and valuable option in patients with early disease.
authors.affiliation: Service d'Immuno-Rhumatologie, Montpellier, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
references.citation: Joint Bone Spine. 2007 Dec;74(6):627-37
references.pmid: 18037319
references.citation: J Dermatolog Treat. 2003 Dec;14(4):229-32
references.pmid: 14660270
references.citation: Lancet. 2000 Jul 29;356(9227):385-90
references.pmid: 10972371
references.citation: J Rheumatol. 2005 Jul;32(7):1232-42
references.pmid: 15996057
references.citation: Arthritis Rheum. 2004 Jul;50(7):2264-72
references.pmid: 15248226
references.citation: JAMA. 2006 Nov 8;296(18):2201-2; author reply 2203-4
references.pmid: 17090760
references.citation: Ann Rheum Dis. 2007 Jul;66(7):880-5
references.pmid: 17324968
references.citation: Arthritis Rheum. 2007 Sep;56(9):2905-12
references.pmid: 17763428
references.citation: J Clin Pharmacol. 2005 May;45(5):490-7
references.pmid: 15831771
references.citation: J Rheumatol. 2006 May;33(5):854-61
references.pmid: 16541481
references.citation: N Engl J Med. 2000 Mar 16;342(11):763-9
references.pmid: 10717011
references.citation: Drugs. 2007;67(8):1211-41
references.pmid: 17521223
references.citation: Arthritis Rheum. 2007 Sep;56(9):2886-95
references.pmid: 17729297
references.citation: Ann Rheum Dis. 2007 May;66(5):670-5
references.pmid: 17158824
references.citation: Arthritis Rheum. 2007 May;56(5):1433-9
references.pmid: 17469100
references.citation: Arthritis Rheum. 2007 Dec;56(12):3928-39
references.pmid: 18050208
references.citation: N Engl J Med. 2000 Nov 30;343(22):1586-93
references.pmid: 11096165
references.citation: Arthritis Rheum. 2007 Sep;56(9):2896-904
references.pmid: 17763441
references.citation: N Engl J Med. 1999 Jan 28;340(4):253-9
references.pmid: 9920948
references.citation: Best Pract Res Clin Rheumatol. 2007 Feb;21(1):27-42
references.pmid: 17350542
references.citation: Arthritis Rheum. 2005 Dec 15;53(6):856-63
references.pmid: 16342093
references.citation: Arthritis Rheum. 2002 Jun;46(6):1443-50
references.pmid: 12115173
references.citation: Ann Rheum Dis. 2007 Jan;66(1):34-45
references.pmid: 16396980
references.citation: Arthritis Rheum. 2006 Jun;54(6):1987-94
references.pmid: 16732547
references.citation: Ann Intern Med. 1999 Mar 16;130(6):478-86
references.pmid: 10075615
references.citation: Ann Rheum Dis. 2007 Nov;66 Suppl 3:iii2-22
references.pmid: 17934088
references.citation: N Engl J Med. 1997 Jul 17;337(3):141-7
references.pmid: 9219699
references.citation: Arthritis Rheum. 2005 Apr;52(4):1216-23
references.pmid: 15818694
references.citation: Arthritis Rheum. 2003 Jan;48(1):218-26
references.pmid: 12528122
references.citation: Ann N Y Acad Sci. 2006 Jun;1069:420-7
references.pmid: 16855169
references.citation: Clin Exp Rheumatol. 2006 Sep-Oct;24(5):587-93
references.pmid: 17181932
references.citation: Rheumatology (Oxford). 2007 Apr;46(4):608-11
references.pmid: 17114801
references.citation: Arthritis Rheum. 2004 Apr;50(4):1040-50
references.pmid: 15077286
references.citation: Arthritis Rheum. 2007 Jun;56(6):1754-64
references.pmid: 17530704
references.citation: J Immunol. 1993 Aug 1;151(3):1548-61
references.pmid: 8393046
references.citation: Clin Ther. 2000 Jan;22(1):128-39
references.pmid: 10688396
references.citation: Arthritis Rheum. 2006 Apr;54(4):1063-74
references.pmid: 16572441
references.citation: Arthritis Rheum. 1995 Apr;38(4):499-505
references.pmid: 7718003
references.citation: Arthritis Rheum. 2006 Sep;54(9):2757-64
references.pmid: 16947774
references.citation: Ann Rheum Dis. 2004 Jun;63(6):665-70
references.pmid: 15037444
references.citation: Best Pract Res Clin Rheumatol. 2006 Dec;20(6):1181-95
references.pmid: 17127203
references.citation: N Engl J Med. 2001 Mar 22;344(12):907-16
references.pmid: 11259725
references.citation: Arthritis Rheum. 2005 Jun;52(6):1766-72
references.pmid: 15934089
references.citation: Ann Rheum Dis. 2006 Nov;65(11):1478-83
references.pmid: 16464988
references.citation: Arthritis Rheum. 2006 Sep;54(9):2807-16
references.pmid: 16947384
references.citation: Rheumatology (Oxford). 2005 Mar;44(3):342-8
references.pmid: 15561737
references.citation: Drugs. 2007;67(17):2609-33
references.pmid: 18034593
references.citation: Semin Arthritis Rheum. 2006 Dec;36(3):159-67
references.pmid: 16884970
references.citation: Arthritis Rheum. 2003 Jun;48(6):1493-9
references.pmid: 12794815
references.citation: Arthritis Rheum. 2004 May;50(5):1412-9
references.pmid: 15146410
references.citation: Drugs. 2002;62(17):2493-537
references.pmid: 12421111
references.citation: Lancet. 2004 Feb 28;363(9410):675-81
references.pmid: 15001324
references.citation: Arthritis Rheum. 2005 Aug;52(8):2447-51
references.pmid: 16052578
references.citation: Arthritis Rheum. 2007 May 15;57(4):639-47
references.pmid: 17471540
references.citation: Ann Rheum Dis. 2004 Dec;63(12):1594-600
references.pmid: 15345498
references.citation: Ann Rheum Dis. 2006 Mar;65(3):328-34
references.pmid: 16079172
references.citation: Ann Rheum Dis. 2006 Oct;65(10):1357-62
references.pmid: 16606651
references.citation: Ann Rheum Dis. 2007 Oct;66(10):1339-44
references.pmid: 17261532
references.citation: N Engl J Med. 2002 May 2;346(18):1349-56
references.pmid: 11986408
references.citation: J Rheumatol. 2004 Mar;31(3):531-8
references.pmid: 14994401