Etanercept shows promise for treating dermatomyositis
A multicenter pilot study of etanercept for treatment of dermatomyositis found no major safety concerns and many patients treated with the drug were successfully weaned from steroid therapy. These results are encouraging, but larger studies are needed to further investigate the safety and efficacy of etanercept. Results of this clinical trial are available in Annals of Neurology, a journal published by Wiley-Blackwell on behalf of the American Neurological Association.
Dermatomyositis is a type of inflammatory myopathy that causes inflammation and progressive weakness in muscles, and is often accompanied by a purple or red skin rash. In some patients the standard treatment for dermatomyositis is prednisone, but despite steroid therapy many patients continue to experience disabling weakness and have the added unpleasant side affects associated with the steroids. Prior studies suggest that tumor necrosis factor (TNF) may play a role in the development of dermatomyositis. TNFa type of protein molecule involved in systemic inflammationis associated with other inflammatory diseases including rheumatoid arthritis, ankylosing spondylitits, and psoriatic arthritis, all of which seem to be responsive to etanercept therapy in studies.
"Given the positive response of other inflammatory diseases to etanercept, our pilot study aimed to assess the safety and tolerability of this drug in dermatomyositis, along with the feasibility of a forced prednisone taper," said Anthony Amato, MD, with the Department of Neurology at Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts. Researchers conducted a double-blind, placebo-controlled trial of etanercept (50 mg weekly) in16 patients with dermatomyositis. The year-long trial randomized 11 participants to etanercept and 5 to placebo, with subjects tapered off prednisone in a standardized schedule over the first 24 weeks of the study.
Trial results revealed no significant increase in adverse event rates in the treatment group compared to placebo. Of the 11 subjects treated with etanercept, 5 were successfully tapered from steroid therapy, with a median time to treatment failure (inability to wean off prednisone on schedule) in this group of 358 days. All placebo subjects were treatment failures with a median of 148 days to failure of treatment. Researchers reported that 5 etanercept-treated participants and 1 placebo-treated participant developed a worsening rash. After week 24 the median of the average prednisone dosage was 29.2 mg/day in the placebo group and 1.2 mg/day in the etanercept cohort.
Additionally, two etanercept-treated participants developed elevated anti-nuclear antibodies during the study, but none developed systemic lupus erythematosus. The authors noted that the small sample size and allowance of rescue treatment in this trial limit conclusions of etanercept efficacy to those related to steroid-sparing. "Etanercept was safe and well-tolerated in participants in our one-year study," concluded Dr. Amato. "Further study of the safety and efficacy of etanercept as a dermatomyositis treatment is warranted."
More information: "A Randomized, Pilot Trial of Etanercept in Dermatomyositis"; Anthony Amato, Rabi Tawil, Michael McDermott, John Kissel, Richard Barohn, Shree Pandya, Wendy King, Alexis Smirnow, Christine Annis, Kristen Roe, Joanne Janciuras, Thomas Cochrane, Merideth Donlan, Samantha Chused, Mazen Dimachkie, Daniel Aires, Kevin Latinis, Laura Herbelin, Edward Cupler, Prinyarat Burusnukul, Thomas Brennan, Miriam Freimer, Gil Wolfe, Sharon Nations, Hannah Briemberg, Judy Wilson, Jan Dutz, Kathryn Wagner, Lisa Christopher-Stine, Grant Anhalt, Jon Meyerle, Regina Brock-Simmons, Amy Bartlett, and Michael Weiss. Annals of Neurology; Published Online: June 17, 2011 (DOI:10.1002/ana.22477).
Provided by
Wiley
-
Etanercept helps restore normal growth in children with juvenile arthritis
Nov 03, 2010 |
not rated yet |
0
-
Latest rheumatoid arthritis drugs compared
Apr 17, 2008 |
not rated yet |
0
-
Type of rheumatoid arthritis medication may be associated with increased risk for shingles
Feb 17, 2009 |
not rated yet |
0
-
Mayo Clinic seeks new therapies for alcoholic hepatitis
Dec 01, 2008 |
not rated yet |
0
-
Rituximab combined with a TNF inhibitor and methotrexate shows no safety signal in RA treatment
Mar 08, 2011 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
How can there be villous adenoma in colon, if there are no villi there
6 hours ago
-
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013
-
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013
-
If you became brain-dead, would you want them to pull the plug?
May 17, 2013
-
MRI bill question
May 15, 2013
-
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013
- More from Physics Forums - Medical Sciences
More news stories
Researchers analyse hunting behaviour of fish larvae in virtual reality
Moving objects attract greater attention – a fact exploited by video screens in public spaces and animated advertising banners on the Internet. For most animal species, moving objects also play a major ...
Neuroscience
31 minutes ago |
not rated yet |
0
|
Signs of motor disorders can appear years before disease manifestation
It is known that signs of neurological disorders such as Alzheimer's and Huntington's disease can appear years before the disease becomes manifest; these signs take the form of subtle changes in the brain and behavior of ...
Neuroscience
35 minutes ago |
not rated yet |
0
Taming suspect gene reverses schizophrenia-like abnormalities in mice
Scientists have reversed behavioral and brain abnormalities in adult mice that resemble some features of schizophrenia by restoring normal expression to a suspect gene that is over-expressed in humans with ...
Neuroscience
2 hours ago |
not rated yet |
0
|
Scientists uncover molecular roots of cocaine addiction in the brain
Researchers at Johns Hopkins have unraveled the molecular foundations of cocaine's effects on the brain, and identified a compound that blocks cravings for the drug in cocaine-addicted mice. The compound, already proven safe ...
Neuroscience
2 hours ago |
not rated yet |
0
|
Addiction as a disorder of decision-making
New research shows that craving drugs such as nicotine can be visualized in specific regions of the brain that are implicated in determining the value of actions, in planning actions and in motivation. Dr. Alain Dagher, from ...
Neuroscience
4 hours ago |
not rated yet |
0
Enzyme-activating antibodies revealed as marker for most severe form of rheumatoid arthritis
In a series of lab experiments designed to unravel the workings of a key enzyme widely considered a possible trigger of rheumatoid arthritis, researchers at Johns Hopkins have found that in the most severe ...
Research offers promising new approach to treatment of lung cancer
Researchers have developed a new drug delivery system that allows inhalation of chemotherapeutic drugs to help treat lung cancer, and in laboratory and animal tests it appears to reduce the systemic damage ...
Overeating learned in infancy, study suggests
In the long run, encouraging a baby to finish the last ounce in their bottle might be doing more harm than good.
Study details genes that control whether tumors adapt or die when faced with p53 activating drugs
When turned on, the gene p53 turns off cancer. However, when existing drugs boost p53, only a few tumors die – the rest resist the challenge. A study published in the journal Cell Reports shows how: tumors that live even i ...
Children of married parents less likely to be obese
Children living in households where the parents are married are less likely to be obese, according to new research from Rice University and the University of Houston.
AIDS scientists optimistic of AIDS cure, for some
Top AIDS scientists were optimistic Wednesday of finding a cure for the disease that has claimed 30 million lives—but said it might not work for all people.