Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis

To date, anti-tumor necrosis factor alfa (anti-TNF-α) therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive...

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Main Authors:	Senabre-Gallego, José Miguel, Santos-Ramírez, Carlos, Santos-Soler, Gregorio, Salas-Heredia, Esteban, Sánchez-Barrioluengo, Mabel, Barber, Xavier, Rosas, José
Format:	Online
Language:	English
Published:	Dove Medical Press 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3790868/

id	pubmed-3790868
recordtype	oai_dc
spelling	pubmed-37908682013-10-07 Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis Senabre-Gallego, José Miguel Santos-Ramírez, Carlos Santos-Soler, Gregorio Salas-Heredia, Esteban Sánchez-Barrioluengo, Mabel Barber, Xavier Rosas, José Review To date, anti-tumor necrosis factor alfa (anti-TNF-α) therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn’s disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept therapy in patients with ankylosing spondylitis. Dove Medical Press 2013-09-23 /pmc/articles/PMC3790868/ /pubmed/24101863 http://dx.doi.org/10.2147/PPA.S33109 Text en © 2013 Senabre-Gallego et al. This work is published by Dove Medical Press Ltd, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Ltd, provided the work is properly attributed.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Senabre-Gallego, José Miguel Santos-Ramírez, Carlos Santos-Soler, Gregorio Salas-Heredia, Esteban Sánchez-Barrioluengo, Mabel Barber, Xavier Rosas, José
spellingShingle	Senabre-Gallego, José Miguel Santos-Ramírez, Carlos Santos-Soler, Gregorio Salas-Heredia, Esteban Sánchez-Barrioluengo, Mabel Barber, Xavier Rosas, José Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis
author_facet	Senabre-Gallego, José Miguel Santos-Ramírez, Carlos Santos-Soler, Gregorio Salas-Heredia, Esteban Sánchez-Barrioluengo, Mabel Barber, Xavier Rosas, José
author_sort	Senabre-Gallego, José Miguel
title	Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis
title_short	Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis
title_full	Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis
title_fullStr	Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis
title_full_unstemmed	Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis
title_sort	long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis
description	To date, anti-tumor necrosis factor alfa (anti-TNF-α) therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn’s disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept therapy in patients with ankylosing spondylitis.
publisher	Dove Medical Press
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3790868/
_version_	1612016485269504000

Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis

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