Efficacy of etanercept for treating the active rheumatoid arthritis: an updated meta-analysis.
OBJECTIVE
To evaluate the efficacy of etanercept (ETA) for treating active rheumatoid arthritis (RA) compared to placebo or methotrexate (MTX).


METHODS
We searched Medline, Cochrane Library and Wiley databases. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to compare efficacy.


RESULTS
In total, 12 studies with 3878 active RA patients (including 2046 patients treated with ETA and 1832 patients treated with placebo or MTX) were included. The overall RRs in ACR20, 50 and 70 (20%, 50%, 70% improvement based on the criteria of American Rheumatism Association) were 2.10 (95% CI: 1.45-3.02, P < 0.0001), 2.87 (95% CI: 1.66-4.97, P = 0.0002) and 2.16 (95% CI: 1.49-3.13, P < 0.0001) within 24 weeks, respectively and were 1.19 (95% CI: 1.11-1.28, P < 0.00001), 1.37 (95% CI: 1.22-1.53, P < 0.00001) and 1.57 (95% CI: 1.28-1.92, P < 0.00001) within 1-3 years, respectively. Further, the overall RRs of 25 mg versus 10 mg ETA twice weekly in ACR20, 50 and 70 were 1.10 (95% CI: 1.02-1.19, P < 0.02), 1.37 (95% CI: 0.98-1.92, P < 0.07) and 1.27 (95% CI: 1.02-1.58, P < 0.03), respectively.


CONCLUSIONS
In active RA patients treated with ETA, there was significantly higher efficacy compared to the treatment of placebo or MTX. High doses of ETA were more effective for active RA patients.
Department of Orthopedics, Shandong Qianfoshan Hospital, Shandong University, Jinan, Shandong, China.
Meng
M
Chen
Department of Orthopedics, Shandong Qianfoshan Hospital, Shandong University, Jinan, Shandong, China.
Dayong
D
Peng
Department of Orthopedics, Taishan Medical University, Jinan, Shandong, China.
Zongzheng
Z
Zhang
Department of Emergency Surgery, Shandong Qianfoshan Hospital, Shandong University, Jinan, Shandong, China.
Guilai
G
Zuo
Department of Emergency Surgery, Shandong Qianfoshan Hospital, Shandong University, Jinan, Shandong, China.
Gang
G
Zhao
D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D016009:Chi-Square Distribution; D000068800:Etanercept / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D016017:Odds Ratio; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D000068800:Etanercept; D008727:Methotrexate
active rheumatoid arthritis; efficacy; etanercept; meta-analysis; tumor necrosis factor