Etanercept Treatment Yields Meaningful Radiographic Outcomes in RA and PsA

Past research has established clinical effectiveness of etanercept in the treatment of rheumatoid arthritis (RA) and psoriatic arthritis (PsA), but its impact on radiographic progression in everyday clinical practice remains unclear. The final results of a non-interventional study evaluating radiographic progression in RA and PsA patients treated with etanercept will be presented at the American College of Rheumatology/Empowering Rheumatology Professionals Annual Meeting.

RA and PsA patients attended up to 10 visits (V): V1 at baseline, V2–V7 every three months until month 18 (phase 1), and V8–V10 every six months until month 36 (phase 2). Patients underwent radiographic evaluation at baseline, month 12–18, and/or months 30–36, the results of which were interpreted by two blind readers using the van der Heijde modified Total Sharp Score (mTSSRA) for RA patients and van der Heijde modified Total Sharp Score adapted (mTSSPsA) for PsA patients. Disease activity score (DAS28) and adverse events (AE)s were also recorded.

Final analysis included 1,821 patients, of whom about three-quarters (75.7%, n = 1,378) were RA patients and the remaining 440 were PsA patients. The RA group had a significantly shorter median disease duration at baseline compared to the PsA group (4.9 years vs. 8.9 years). Among RA patients, the mean mTSSRA increased from 25.1 (n = 504) at baseline to 26.2 (n = 284) at the end of phase 1 and to 29.8 (n = 74) at the end of phase 2. Among PsA patients, mean mTSSPsA did not largely change from baseline (14.7, n = 166) to phase 1 (14.6, n = 80) and decreased slightly at the end of phase 2 (12.6, n = 35). At 24 months, radiographic non-progression was observed in 64.2% of RA patients and 68.9% of PsA patients. Mean DAS28 in RA patients decreased from 4.6 (n = 1,014) at baseline to 2.6 (n = 190) at month 36, and in PsA patients, decreased from 4.2 (n = 327) to 2.5 (n = 88). At month 36, 61.6% and 64.8% of RA and PsA patients, respectively, had a DAS <2.6 and were considered to be in remission. Less than half (n = 849, 46.6%) of patients sustained a treatment-emergent AE (n = 1,993); most AEs were considered mild (768 events in 377 patients, 20.7%) or moderate (825 events in 481 patients, 26.4%). A total of 753 AEs related to etanercept treatment occurred in 446 (24.5%) patients, of which 62 events in 47 patients (2.6%) were classified as serious adverse drug reactions.

The researchers stated in summary that etanercept could slow or halt radiographic progression and reduce disease activity in patients with RA and PsA receiving routine clinical care.