Arthritis Drugs & New Medications-2001 Meeting (cont.)

ENBREL (etanercept)

Enbrel is an injectable anti-tumor necrosis factor for treating rheumatoid arthritis. Tumor necrosis factor (TNF) is a protein that the body produces during the inflammatory response, which is the body's reaction to injury. TNF promotes the inflammation and its associated fever and signs (pain, tenderness, and swelling) in several inflammatory conditions, including rheumatoid arthritis. Enbrel is a synthetic (man-made) protein that binds to TNF. Enbrel thereby acts like a sponge to remove most of the TNF molecules from the joints and blood. This prevents TNF from promoting inflammation and the fever, pain, tenderness, and swelling of joints in patients with rheumatoid arthritis (and apparently other forms of inflammatory arthritis, such as psoriatic arthritis, ankylosing spondylitis, and juvenile arthritis-see below).

Enbrel plus methotrexate was reported at this meeting to be more effective than Enbrel alone.

Dr. Shiel's Perspective: This may be true, to a degree, for both Enbrel and Remicade, but I use them individually or with methotrexate or other drugs on a case by case basis.

The long-term safety of Enbrel in more than 2,600 patients over 5 years was reported. There was no cumulative toxicity with extended use and the clinical response was sustained for up to 5 years of the study.

Dr. Shiel's Perspective: These long-term statistics are very helpful for doctors who are assessing the value of this relatively new treatment for rheumatoid arthritis.

Enbrel was found to be safe when used in combination with Kineret (see below).

Dr. Shiel's Perspective: A combination therapy using more than one antirheumatic drug is commonly necessary in the treatment of certain patients with rheumatoid arthritis. This combination awaits further studies of Kineret before it is used commercially.

Enbrel increases general functioning of patients with rheumatoid arthritis.

Dr. Shiel's Perspective: This is important for doctors in office practice because we want to help our patients get to their optimal functional status.

Enbrel was found to be effective in patients with juvenile rheumatoid arthritis.

Dr. Shiel's Perspective: Enbrel is already approved for the use in treating juvenile rheumatoid arthritis that has not responded to other disease-modifying rheumatic drugs.

Enbrel was reported as effective for treating psoriatic arthritis and ankylosing spondylitis. For those with psoriasis, Enbrel not only helped the arthritis, but also helped to clear the psoriasis, often dramatically. In those treated with Enbrel, there were no serious, unforeseen side effects.