Etanercept treatment of psoriatic arthritis: Safety, efficacy, and effect on disease progression

Abstract

Objective. Etanercept has been shown to improve the articular and cutaneous manifestations of psoriatic arthritis (PsA). In this study, we further evaluated the safety, efficacy, and effect on radiographic progression of etanercept in patients with PsA.Methods. Patients with PsA (n ‫؍‬ 205) were randomized to receive placebo or 25 mg etanercept subcutaneously twice weekly for 24 weeks. Patients continued to receive blind-labeled therapy in a maintenance phase until all had completed the 24-week phase, then could receive open-label etanercept in a 48-week extension. Efficacy and safety were evaluated at 4, 12, and 24 weeks and at 12-week intervals thereafter. Radiographs of the hands and wrists were assessed at baseline and 24 weeks, at entry to the open-label phase, and after 48 weeks in the study.Results. Etanercept significantly reduced the signs and symptoms of PsA and psoriasis. At 12 weeks, 59% of etanercept patients met the American College of Rheumatology 20% improvement criteria for joint response, compared with 15% of placebo patients (P < 0.0001), and results were sustained at 24 and 48 weeks. At 24 weeks, 23% of etanercept patients eligible for psoriasis evaluation achieved at least 75% improvement in the Psoriasis Area and Severity Index, compared with 3% of placebo patients (P ‫؍‬ 0.001). Radiographic disease progression was inhibited in the etanercept group at 12 months; the mean annualized rate of change in the modified total Sharp score was ؊0.03 unit, compared with ؉1.00 unit in the placebo group (P ‫؍‬ 0.0001). Etanercept was well tolerated.Conclusion. Etanercept reduced joint symptoms, improved psoriatic lesions, inhibited radiographic progression, and was well tolerated in patients with PsA.

Brief Report: Secukinumab Provides Significant and Sustained Inhibition of Joint Structural Damage in a Phase III Study of Active Psoriatic Arthritis

“…However, failure of anti‐TNF treatment, loss of efficacy, and intolerance in some patients highlight the unmet need for new therapies with an alternative mechanism of action 12. The radiographic findings from this study are consistent with those from other trials of TNF and IL‐12/23 inhibitors involving anti‐TNF–naive populations 13, 14, 15, 16, 17 and suggest that IL‐17A may offer an additional therapeutic option for patients with PsA.…”

Golimumab, a new human tumor necrosis factor α antibody, administered every four weeks as a subcutaneous injection in psoriatic arthritis: Twenty‐four–week efficacy and safety results of a randomized, placebo‐controlled study

“…Anti-tumor necrosis factor ␣ (anti-TNF␣) agents improve the arthritic and psoriatic manifestations of PsA (2)(3)(4). Golimumab is a new human monoclonal antibody against TNF␣ that binds with high affinity and specificity to soluble and transmembrane TNF␣ and has a median terminal half-life of ϳ2 weeks (5).…”

Validation of minimal disease activity criteria for psoriatic arthritis using interventional trial data

“…There is some evidence of the link between inflammation and damage in PsA, where observational studies have shown that active inflammatory disease predicts future outcome (1). New therapies, such as the tumor necrosis factor ␣ blockers, have shown a reduction in disease activity and a corresponding reduction in radiographic progression of damage (2)(3)(4). Ongoing joint damage can cause significant functional impairment and disability, which raises the possibility that controlling disease activity could improve outcome.…”