Etanercept for treating axial spondyloarthritis

Abstract

Axial spondyloarthritis is an inflammatory rheumatic disease causing back pain, functional impairment and potential ankylosis in the advanced stage. In this context, TNF blockers have been a major therapeutic advance. Etanercept is a soluble recombinant TNF receptor fusion protein in this vain. Areas covered: The aim of this review is to summarize the current published data concerning the efficacy and tolerance of etanercept in axial spondyloarthrits. The authors performed a systematic review on PubMed, using 'etanercept' and 'spondyloarthritis', 'axial spondyloarthritis' or 'ankylosing spondylitis' keywords. Expert opinion: Etanercept showed clinical efficacy on the axial (non-radiographic and radiographic) and peripheral manifestations (peripheral arthritis and enthesitis) of axial spondyloarthritis (Ax-SpA). Among the extra-articular manifestations, it works on psoriasis but not on inflammatory bowel disease, with a lack of efficacy data in anterior uveitis. Etanercept also demonstrated an interesting tolerance profile and good drug survival rates after 5 years. Etanercept was also shown to reduce MRI inflammation on the spine and the sacroiliac joints. However, like other TNF blockers, its impact on radiographic progression could not be fully demonstrated. In the context of upcoming new biologic targeted treatments, head-to-head and longer-term randomized controlled trials are now required to further define the role of etanercept in spondyloarthritis treatment strategies.

High Levels of Tumor Necrosis Factor-Alpha Reduce Placental Aquaporin 3 Expression and Impair in vitro Trophoblastic Cell Migration

“…This cytokine is majorly secreted by Th1 lymphocytes, and TNF-α is frequently involved in inflammatory and immunological processes occurring during arterial hypertension (Barbaro et al, 2015 ). Etanercept is a soluble recombinant TNF receptor that acts by inhibiting TNF-α action (Guillot et al, 2017 ). The reduced BP observed in SHRs treated with etanercept indicates that TNF-α plays a role in the maintenance of BP elevation, supporting the idea that TNF-α is part of the pathophysiology of high BP (Mehaffey and Majid, 2017 ; Lu and Crowley, 2018 ).…”

Enthesopathy in spondyloarthritis: the literature review

“…ЭТЦ был эффективен в терапии энтезита у пациентов с ПсА и АС. В то же время при энтезите у больных ВЗК эффект не был получен [70,71]. При назначении инфликсимаба (ИНФ) больным ПсА отмечалось значительное снижение выраженности энтезита на 16-й неделе, сохранявшееся в течение всего периода терапии и через год после отмены препарата.…”

Identification of Key Genes and Pathways in Ulcerative Colitis Through Bioinformatics Analysis

“…Moreover, etanercept, interferon alfa-2b, mycophenolicacid and procarbazine are associated with more than one gene. Etanercept (Enbrel) is used for the treatment of rheumatoid arthritis and axial spondyloarthritis, two diseases with in ammation as the main phenotype [23][24][25]. Interferon alfa-2b is an enhancing promotor in immune system, which is used in the treatment of mucosal melanoma of the head and neck [26], recurrent conjunctival papillomatosis [27], ocular surface squamous neoplasia [28], and several types of cancers.…”