Etanercept showing promise in erosive hand osteoarthritis

Researchers in the Netherlands have made the case for further research on the use of subcutaneous etanercept (Enbrel—Immunex) to treat osteoarthritis of the hand. The trial enlisted 90 patients, randomized to either receive or not receive the drug at 50 mg per week for 24 weeks followed by a lower dose for 1 year.

Researchers in the Netherlands have made the case for further research on the use of subcutaneous etanercept (Enbrel—Immunex) to treat osteoarthritis of the hand. The trial enlisted 90 patients, randomized to either receive or not receive the drug at 50 mg per week for 24 weeks followed by a lower dose for 1 year. Those not assigned to take etanercept were given placebos. The primary outcome—lower pain scores at 24 weeks—was not achieved across the study population, but a benefit was demonstrated for a specific subset of patients. For those who completed the full course of etanercept, pain was markedly lower at 1 year compared with the placebo group. Meanwhile, in terms of structural damage—as gauged by joint space, subchondral bone plate, and subchondral bone architecture—there was notably more remodeling at 1 year with etanercept. Reporting at the European League Against Rheumatism Congress 2016, Margaret Kloppenburg, MD, professor at the Leiden University Medical Centre, confirmed that "in patients who met our stringent inclusion criteria—who were symptomatic and who had inflammation on study entry—and who finished the year-long trial, etanercept was superior to placebo on measures of both pain and erosive evolution, and it was especially effective in joints with soft tissue swelling." She acknowledged that the investigation was only a proof-of-concept trial and that much more work must be done to identify a target population as well as optimal doses and therapy duration.