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Ankylosing spondylitis patients maintained remission after etanercept dose reduction
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More than 50% of patients with ankylosing spondylitis who were treated with 50 mg etanercept weekly had disease remission, and a high percentage of those patients maintained remission when the dose was administered biweekly, according to study results.
In a randomized, follow-up study, researchers in Italy evaluated 78 patients with ankylosing spondylitis (median age, 38 years; 57 men; median disease duration, 12 years) who were treated with etanercept 50 mg weekly between 2005 and 2009. Patients with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores of less than 4, no extra-axial manifestations of peripheral arthritis, dactylitis, tenosynovitis or iridocyclitis, and those with normal acute-phase reactants were determined to be in remission.
In January 2010, 43 patients (55.1%) achieved remission after a mean follow-up of 25 ± 11 months and were randomly assigned to two treatment groups: 22 received 50 mg etanercept biweekly, and 21 received 50 mg etanercept weekly. At follow-up, 19 patients (86.3%) receiving etanercept biweekly (mean follow-up, 22 ± 1 months) and 19 (90.4%) receiving therapy weekly (mean follow-up, 21 ± 1.6 months) maintained remission. The groups displayed no significant differences in C-reactive protein, erythrocyte sedimentation rate, BASDAI and other variables. Three patients in the every-other-week treatment group and four in the weekly treatment group experienced mild injection site reactions.
“The sustained disease remission after reduction of the etanercept dose suggests that this therapeutic strategy can be applied in clinical practice, with important advantages in terms of drug exposure risk, patient compliance with therapy and cost savings,” the researchers concluded.
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