Rheumatoid arthritis etanercept

Soluble receptor constructs Etanercept This genetically engineered drug consists of the extracellular-part of the TNF-receptor type I and the Fc portion of human IgG. Its application in rheumatoid arthritis mirrors that of infliximab. 

Enbrel Etanercept Immunex Corporation Rheumatoid arthritis... 

Kang, C. P. et al., The influence of a polymorphism at position -857 of the tumour necrosis factor alpha gene on clinical response to etanercept therapy in rheumatoid arthritis, Rheumatology (Oxford), 44, 547, 2005. 

Moreland, L.W. et al., Etanercept treatment in adults with established rheumatoid arthritis 7 years of clinical experience, J. Rhematol., 33, 854, 2006. 

Brion, P.H., Mittal-Henkle, A., and Kalunian, K.C., Autoimmune skin rashes associated with etanercept for rheumatoid arthritis [letter], Awn. Intern. Med., 131, 634, 1999. 

Bathon, J.M., Martin, R.W., Fleischmann, R.M., et al. (2001) A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis. New England Journal of Medicine. 343,1586-1593. 

Culy CR, Keating GM. Etanercept. An updated review of its use in rheumatoid arthritis, psoriatic arthritis and juvenile rheumatoid arthritis. Drugs 2002 62 2493-537. 

Etanercept is a recombinant human soluble tumor necrosis factor-alpha (TNFo ) receptor fusion protein that binds to TNFo and decreases its role in disorders involving excess inflammation. It is approved for subcutaneous use in the treatment of patients with moderate to severe active rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing arthritis and plaque psoriasis. To the adverse reactions mentioned for infliximab, rare reports of congestive heart failure should be added. 

Infliximab is a monoclonal antibody against TNF-a (see Chapter 26, Section III.d.1). It has been approved for the treatment of psoriasis, Crohn s disease, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis and ulcerative colitis. Similar immunosuppressants are etanercept, and adali-mumab. 

Two recently introduced biological therapies were designed to interfere with the inflammatory cascade initiate by TNF-a. Etanercept (Enbrel) is indicated for the treatment of moderate to severe rheumatoid arthritis in individuals over age 4. Infliximab in conjunction with methotrexate (Remicade) is approved for use by adults in the treatment of rheumatoid arthritis. It is also indicated for therapy of Crohn s disease. Over the short term, the efficacy of these drugs in the treatment of rheumatoid arthritis appears to be superior to that of methotrexate alone however, their ability to prevent bone erosion for longer than 24 months must be further studied. The cost of both drugs is significantly higher than that of the other DMARDs. 

Etanercept is approved in the United States for the treatment of psoriatic arthritis and rheumatoid arthritis. Although etanercept has not been specifically approved for the treatment of the cutaneous manifestations of psoriasis, it significantly improves the skin lesions of patients with moderate to severe cutaneous psoriasis who have used it for psoriatic joint disease. 

C. Hydroquinone inhibits the enzyme tyrosine kinase, which converts tyrosine to melanin. It also damages melanocytes. Becaplermin (A) is a recombinant human platelet-derived growth factor that is useful in enhancing wound healing. Etanercept (B) is a recombinant fusion protein approved for treatment of psoriatic arthritis and rheumatoid arthritis. Botulinum toxin (D) is a purified form of bofu-linum foxin fype A approved for fherapy of blepharospasm and sfrabismus. 

Garrison L, McDonnell ND Etanercept Therapeutic use in patients with rheumatoid arthritis. Ann Rheum Dis 1999 58(Suppl I) I165. 

Moreland LW et al Etanercept therapy in rheumatoid arthritis. A randomized, controlled trial. Ann Intern Med 1999 130 478. [PMID 10075615]... 

Etanercept is a dimeric fusion protein composed of human IgGj constant regions (CH2, CH3, and hinge, but not CH ) fused to the TNF receptor. Etanercept binds to both TNF- and TNF-3 and appears to have effects similar to that of infliximab, ie, inhibition of TNF-K-mediated inflammation, but its half-life is shorter due to its physical form (fusion protein) and the route of injection (subcutaneously, twice weekly). Etanercept is approved for adult rheumatoid arthritis, polyarticular-course juvenile rheumatoid arthritis, and psoriatic arthritis. It may be used in combination with methotrexate. 

Etanercept is a genetically engineered protein that is soluble TNF-a receptor. Its molecular weight is 75kDa. It binds to TNF-a. It is used for the treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Structurally, two TNF-a receptors are linked to an Fc portion of an... 

Transient hyperthyroidism occurred after 6 months of etanercept treatment in a 37-year-old woman with rheumatoid arthritis (388). 

Type 1 diabetes mellitus occurred after 5 months treatment with etanercept for juvenile rheumatoid arthritis in a 7-year-old girl (389). Antiglutamic acid decarboxylase antibodies were positive both before and during treatment, suggesting that etanercept may have prematurely triggered an underlying disease. 

Bloom BJ. Development of diabetes mellitus during etanercept therapy in a child with systemic-onset juvenile rheumatoid arthritis. Arthritis Rheum 2000 43(ll) 2606-8. 

Blumenauer B, Judd M, Cranney A, et al. Etanercept for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2003 CD004525. 

Etanercept Enbrel Rheumatoid arthritis psoriatic arthritis 1998... 

Etanercept is dimeric fusion protein that consists of the extracellular ligandbinding protein of the human 75-kDa tumor necrosis factor (TNF) receptor linked to the Fc portion of human IgC, immunoglobulin. Etanercept has a short half-life (3-6 days) and is administered at doses of 25 mg SC twice weekly [62]. The population PK/PD of etanercept were described recently [63]. Following SC administration of the protein at 25 mg and 50 mg twice weekly doses in rheumatoid arthritis (RA) patients, linear pharmacokinetic behavior was ob-... 

Fig. 12.6 (A) Predicted serum concentrationtime profiles for etanercept following subcutaneous administration of the low (25 mg once weekly), medium (25 mg twice weekly), and high (50 mg twice weekly) dose in rheumatoid arthritis patients using the population pharmacokinetic model described previously...

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