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Intra-articular Enbrel may treat rheumatoid and psoriatic arthritis
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Patients with rheumatoid or psoriatic arthritis showed improvement after a single, intra-articular injection with 25 mg Enbrel after 1 week and 2 weeks, according to the results of this study.
The 6-week study included 30 patients with psoriatic arthritis (PsA) or rheumatoid arthritis (RA) who had active arthritis based on established criteria in at least one joint, despite a stable dose of methotrexate and/or prednisone for at least 4 weeks. The investigators excluded patients taking additional disease-modifying anti-rheumatic drugs, intra-articular or intramuscular injections of corticosteroids 3 months prior to the study, and patients with a current or history of infection, cancer in the preceding 10 years or other severe comorbidity.
Patients were evaluated at baseline, weekly through 4 weeks and again at 6 weeks for disease activity, joint pain on a VAS, functional disability and clinical assessment of the target joint. Laboratory evaluations included measurements of erythrocyte sedimentation rate, C-reactive protein and antibodies to etanercept.
Twenty-two patients were randomized to receive an intra-articular injection of 25-mg Enbrel (etanercept; Pfizer) and eight patients received placebo identical in appearance at a volume of 1 mL in one targeted joint. Twenty patients who received etanercept underwent knee injections, and two patients received metacarpophalangeal injections. Of the patients who received placebo, seven received knee injections, one received an ankle injection and one received a metacarpophalangeal injection.
A statistically significant improvement was observed at week 1 and week 2 following injection in 55% of the patients who received etanercept, while no patients in the placebo group improved. The effect on all parameters persisted for 1 week to 2 weeks, with the exception of joint tenderness, which remained improved at 6 weeks. Two patients with PsA displayed sustained effects at 6 weeks. Flu-like or gastrointestinal symptoms were the most common adverse events reported by seven patients who received etanercept and two patients who received placebo. No serious adverse events were reported, and antibodies to etanercept were not detected in any patient. – by Shirley Pulawski
Disclosure s : Aalbers reports an affiliation with Arthrogen BV, the study sponsor. Please see the full study for a list of all other authors’ relevant financial disclosures.
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