title: Efficacy and safety of etanercept in chronic immune-mediated disease.
abstract: BACKGROUND
  TNF-α inhibitors have demonstrated efficacy in large, randomized controlled clinical trials either as monotherapy or in combination with other anti-inflammatory or disease-modifying antirheumatic drugs in the treatment of chronic inflammatory immune-mediated diseases. Etanercept is a fusion protein that acts as a 'decoy receptor' for TNF-α.
  
  
  METHODS
  This paper evaluates the efficacy and safety of etanercept in patients with chronic inflammatory immune-mediated diseases.
  
  
  CONCLUSIONS
  Etanercept was first approved for the treatment of rheumatoid arthritis (RA) and subsequently of chronic plaque psoriasis, psoriatic arthritis, ankylosing spondylitis and juvenile RA. Etanercept as other TNF-α inhibitors, particularly infliximab, may be administered off-label to treat other chronic inflammatory immune-mediated diseases such as systemic sclerosis, Behcet disease, systemic lupus erythematosus, polymyositis, dermatomyositis and mixed connective tissue disease. Early etanercept treatment prevents joint damage and helps to avoid long-term disability in arthritis. Etanercept administered at a dose of 50 mg once weekly is effective in inducing an earlier remission of RA, and etanercept 50 mg twice weekly may favor a more rapid improvement of psoriasis and psoriatic arthritis. Etanercept and adalimumab may exert beneficial effects on lipid profile and improve endothelial dysfunction. Appropriate screening tests for latent tuberculosis, hepatitis B virus and hepatitis C virus should be performed before starting etanercept. TNF-α inhibitors including etanercept are contraindicated in patients with demyelinating diseases.
authors.affiliation: University of Genova, Department of Internal Medicine, Clinical Immunology Unit , Viale Benedetto XV, n. 6, 16132 Genova , Italy +39 010 353 7924 ; +39 010 555 6950 ; Giuseppe.Murdaca@unige.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Murdaca
authors.forename: Francesca
authors.initials: F
authors.lastname: Spanò
authors.forename: Miriam
authors.initials: M
authors.lastname: Contatore
authors.forename: Andrea
authors.initials: A
authors.lastname: Guastalla
authors.forename: Ottavia
authors.initials: O
authors.lastname: Magnani
authors.forename: Francesco
authors.initials: F
authors.lastname: Puppo
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D001327:Autoimmune Diseases / Q000188:drug therapy*; D002908:Chronic Disease; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept