title: Effectiveness and safety of etanercept in patients with psoriatic arthritis in a Canadian clinical practice setting: the REPArE trial.
abstract: OBJECTIVE
  To describe the longterm effectiveness and safety of etanercept in Canadian patients with psoriatic arthritis (PsA), treated over 24 months in clinical practice.
  
  
  METHODS
  Patients with active PsA (≥ 3 tender and ≥ 3 swollen joints) were recruited from 22 centers. Etanercept was administered at 50 mg/week subcutaneously. In addition to clinical assessment of skin and joint disease, conducted at baseline and at Months 6, 12, 18, and 24, regular patient interviews were conducted by telephone. Patient responses related to health status, disability, and work productivity were scored using the patient global assessment tool, the Health Assessment Questionnaire (HAQ), the Health and Labour Questionnaire (HLQ), and the Fatigue Severity Scale.
  
  
  RESULTS
  Out of 110 patients, 71 (65%) maintained etanercept treatment through the end of our study. All clinical measures of disease severity, including joint tenderness/pain, joint swelling, and Psoriasis Area and Severity Index score, improved significantly between baseline and Month 6 of etanercept treatment and remained constant thereafter. By the end of our study, 79% of patients achieved a Psoriatic Arthritis Response Criteria response, and 56% of patients achieved a 0.5-point improvement on HAQ, indicating clinically significant improvement in disability; 14% of patients finished our study free of disability (HAQ = 0). Patients' work productivity and fatigue improved significantly in parallel with these clinical and functional improvements.
  
  
  CONCLUSIONS
  Continuous treatment with etanercept over 2 years in a clinical setting improved clinical symptoms of PsA while reducing fatigue, improving work productivity, and ameliorating or eliminating disability.
authors.affiliation: Toronto Western Hospital (University of Toronto) and University Health Network, Toronto, Ontario, Canada. dafna.gladman@utoronto.ca
authors.forename: Dafna D
authors.initials: DD
authors.lastname: Gladman
authors.forename: Claire
authors.initials: C
authors.lastname: Bombardier
authors.forename: Carter
authors.initials: C
authors.lastname: Thorne
authors.forename: Boulos
authors.initials: B
authors.lastname: Haraoui
authors.forename: Majed
authors.initials: M
authors.lastname: Khraishi
authors.forename: Proton
authors.initials: P
authors.lastname: Rahman
authors.forename: William
authors.initials: W
authors.lastname: Bensen
authors.forename: Jerry
authors.initials: J
authors.lastname: Syrotuik
authors.forename: Melanie
authors.initials: M
authors.lastname: Poulin-Costello
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000503:physiopathology; D002170:Canada; D004185:Disability Evaluation; D004526:Efficiency / Q000502:physiology; D000068800:Etanercept; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006304:Health Status; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use*; D015994:Incidence; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept