Efficacy and safety of etanercept

Etanercept was the first TNF-alpha inhibitor to be approved for first-line treatment of moderate to severe plaque psoriasis and psoriatic arthritis

The authors of this paper have reviewed the available data on its long-term efficacy and safety.

They investigated the results of several clinical trials into patients with psoriasis and psoriatic arthritis who were treated with etanercept. They found etanercept to be effective in the long-term treatment of psoriasis and that it was associated with a significant reduction in the risk of MI. It was also linked with a trend toward a reduction in the prevalence of metabolic syndrome after two years of therapy.

They also found etanercept to be effective in the long-term treatment of psoriatic arthritis, with an associated beneficial effect on the prevention of further radiographic disease progression.

Etanercept was found to be generally well tolerated. Its safety appeared to be similar in patients who tested positive for antibodies to etanercept and in those who tested negative.

The most common reported side-effects were injection site reactions, headache, arthralgia, back pain, URTIs, nasopharyngitis, sinusitis and influenza. Rarer reported severe side-effects included cellulitis, pneumonia, hypoaesthesia, paraesthesia, dyspnoea, viral meningitis, subdural haematoma, MI, nephrolithiasis, depression, basal cell carcinoma and an increased risk of squamous cell carcinoma.

The authors concluded that etanercept has demonstrated long-term efficacy both as monotherapy and in combination with other psoriasis treatments. They also postulated that the risk of severe side-effects is small and the benefit of treating patients with psoriasis with etanercept outweighs the risks.

Kivelevitch D, Mansouri B, Menter A. Biologics 2014; 8: 169-82

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