Etanercept may be a useful treatment for psoriatic rheumatoid arthritis and psoriasis, say researchers.
Dr Philip Mease and colleagues (Minor and James Medical, Seattle, US) undertook a randomised, controlled trial of two groups of 30 patients to compare the efficacy of etanercept with placebo in psoriatic arthritis and psoriasis.
After treatment for 12 weeks, the etanercept group showed significant improvement in all measures of disease activity, including reduced skin lesions, joint tenderness and joint swelling, compared with the placebo group. "This trial shows that etanercept provides clinically significant benefit to patients with active psoriatic arthritis," the researchers say.
Patients were given an injection of either 25mg of etanercept or placebo subcutaneously each week for 12 weeks.
The primary endpoint for psoriatic arthritis was the proportion of patients who met the Psoriatic Arthritis Response Criteria (PsARC) at 12 weeks (ie, improvement in two and worsening in none of the following factors - patient and physician global assessment, tenderness and swelling of the joints). The endpoint for psoriasis was the proportion of patients achieving a 75 per cent improvement in psoriasis activity over the 12-week period.
The PsARC was met by 87 per cent of patients in the etanercept group compared with 23 per cent of those receiving placebo. The median percentage improvements in tender and swollen joints for etanercept patients were 75 and 72 per cent, respectively, and 5 and 19 per cent in the placebo group. Of the 19 patients who had evaluable psoriasis, five achieved a 75 per cent improvement compared with no patients in the placebo group. Patients receiving etanercept reported no serious adverse events.
Etanercept (Enbrel) is a competitive inhibitor of tumour necrosis factor that is licensed for the treatment of active rheumatoid arthritis in adults and in children aged between four and 17 who have polyarticular-course juvenile chronic arthritis.