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 a term called "intestinal metaplasia" of stomach
9 hours ago Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
- More from Physics Forums - Medical Sciences
More news stories
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
Neuroscience 3 hours ago | 4.7 / 5 (3) | 0 |
You're standing near an airport luggage carousel and your bag emerges on the conveyor belt, prompting you to spring into action. How does your brain make the shift from passively waiting to taking action when ...
Neuroscience 3 hours ago | not rated yet | 0 |
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
Neuroscience 5 hours ago | 4 / 5 (4) | 0 |
In a remote fishing community in Venezuela, a lone fisherman sits on a cliff overlooking the southern Caribbean Sea. This man –– the lookout –– is responsible for directing his comrades on the water, ...
Neuroscience 7 hours ago | 4 / 5 (1) | 0 |
A drug commonly used to treat depression and anxiety may improve a stress-related heart condition in people with stable coronary heart disease, according to researchers at Duke Medicine.
30 minutes ago | not rated yet | 0 |
(HealthDay)—The overall health of Americans isn't improving much, with about six in 10 people either overweight or obese and large numbers engaging in unhealthy behaviors like smoking, heavy drinking or ...
40 minutes ago | not rated yet | 0
(HealthDay)—In 2008 to 2010, the prevalence of key health behaviors among U.S. adults varied, with about one in five adults current smokers and 62.1 percent overweight or obese, according to a report presented ...
30 minutes ago | not rated yet | 0
(HealthDay)—Factors such as increased case finding may explain why Michigan had half of the total spinal infections associated with contaminated methylprednisolone acetate in the recent fungal meningitis ...
20 minutes ago | not rated yet | 0
Early use of tracheostomy for mechanically ventilated patients not associated with improved survival
For critically ill patients receiving mechanical ventilation, early tracheostomy (within the first 4 days after admission) was not associated with an improvement in the risk of death within 30 days compared to patients who ...
30 minutes ago | not rated yet | 0
(HealthDay)—Three-quarters of public schools in the metro Atlanta area contain microbes, including bacteria indicating the presence of fecal matter, according to research published in the May 17 issue of ...
10 minutes ago | not rated yet | 0