Efficacy and safety of etanercept in chronic immune-mediated disease

Abstract

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.

The association of NLRP3 and TNFRSF1A polymorphisms with risk of ankylosing spondylitis and treatment efficacy of etanercept

“…Currently, there are a few TNF‐α inhibitors available for clinical treatments. These inhibitors act to block the binding of TNF‐α to its receptors and therefore, interfering with TNF‐α signaling transduction pathways, such as anti‐TNF‐α mAbs (golimumab, adalimumab, infliximab, and certolizumab pegol) and etanercept (a fusion protein which acts as a “decoy receptor” for TNF‐α) . Etanercept is composed of two p75 TNF receptors fused with the Fc portion of human IgG1.…”

“…It is generally administered subcutaneously 25 mg/d twice a week or 50 mg once a week . Etanercept binds to TNF (primarily to its soluble form) with a high affinity and blocks the effects of TNF …”

“…These inhibitors act to block the binding of TNFα to its receptors and therefore, interfering with TNFα signaling T A B L E 1 1 Association between TFRSF1A haplotypes and tradition treatment for AS (primarily to its soluble form) with a high affinity and blocks the effects of TNF. 42,45 Our studies have demonstrated that there are obvious differences in the sedimentation rate (ESR) level, waist duration of morning stiffness and BASFI between traditional medicine and etanercept treatment patients. We also observed no significant differences in VAS, CRP between the two groups.…”

Patient reports of the frequency and severity of adverse reactions associated with biological agents prescribed for psoriasis in Brazil

“…Because TNF-a is essential for the control of cytotoxic metabolites, thereby increasing phagocytic killing activity of macrophages and other killer cells, anti-TNF-a medication can predispose to common as well as opportunistic infections [15,18].…”

Etanercept-Associated Transient Bone Marrow Aplasia: A Review of the Literature and Pathogenetic Mechanisms

“…In conclusion, TNFα antagonists for the treatment of RA show significant benefit and are generally safe in comparison with other disease-modifying anti-rheumatic drugs [27–29]. BM suppression resulting in severe cytopenia, transient pancytopenia, or aplastic anemia is a well established but fortunately rare SAE of anti-TNFα therapy.…”