Etanercept: An overview

https://doi.org/10.1016/mjd.2003.554Get rights and content

Abstract

Etanercept, a competitive inhibitor of TNF-α, is currently FDA approved for psoriatic arthritis and rheumatoid arthritis. The molecular structure of etanercept, its mechanism of action, and results of clinical trials involving patients with psoriasis will be reviewed.

Section snippets

Etanercept structure and mechanism of action

Etanercept is a fully human dimeric fusion protein consisting of the extracellular ligand-binding domain of the human 75 kilodalton (kDa) TNF-α receptor linked to the Fc portion of human immunoglobulin G1 (IgG1). Despite the presence of an Fc region, etanercept does not promote complement-mediated cell lysis in vitro.3 Etanercept has been shown to have a very low (<2%) rate of immunogenicity when studied in patients with psoriasis, psoriatic arthritis, rheumatoid arthritis, and congestive heart

Etanercept safety

The safety of etanercept has been demonstrated in more than 130,000 patient-years of exposure in both controlled clinical trials and in post-marketing surveillance. In controlled trials, the only adverse event that occurred significantly more frequently in patients treated with etanercept compared to placebo was mild to moderate injection site reactions (erythema and/or itching, pain, or swelling), in approximately 37% of patients receiving etanercept.3 These reactions tended to occur in the

Conclusion

Etanercept has demonstrated consistent efficacy in the treatment of inflammatory diseases such as psoriasis, psoriatic arthritis, RA, and JRA. Research on the potential future use of etanercept in other inflammatory diseases is ongoing. The rapid and significant clinical responses to this agent underscore both the central role of TNF-α in contributing to the pathology of these diseases, and the potent inhibitory effects of etanercept on its ability to do so. Etanercept is well tolerated by both

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    Funding sources: None.

    Disclosure: Drs Cather and Goffe have participated in clinical trials involving Enbrel. Dr Goffe is involved in trials funded by Immunex (now Amgen), Biogen, Genentech, Corixa, IDEC, Boehringer-Ingelheim, ISIS, Fujisawa, and Bristol Meyers. Dr Goffe is on the speaker’s bureau for Amgen; however, he is not a paid consultant.

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