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A Canadian study has demonstrated the effectiveness of the anti-TNF therapy etanercept in the treatment of non-radiographic axial spondyloarthritis.
Axial spondyloarthritis is a debilitating condition that causes chronic back pain and stiffness - often in younger adults - and includes ankylosing spondylitis.
However, non-radiographic axial spondyloarthritis differs from ankylosing spondylitis as there is no X-ray evidence of structural damage, meaning it can often go unrecognised for years.
The University of Alberta research aimed to compare the efficacy and safety of the biologic therapy to placebo after 48 weeks in patients with early active non-radiographic axial spondyloarthritis, with results published in the Annals of the Rheumatic Diseases.
Patients were randomised to receive either etanercept in a 50 mg per week dose or a placebo for 12 weeks, then open-label etanercept for the remainder of the trial. Clinical, health, productivity, magnetic resonance imaging (MRI) and safety outcomes were assessed after 48 weeks.
Of the 225 patients, 205 entered the open-label phase at week 12. The percentage of patients achieving a positive clinical response increased from 33 per cent to 52 per cent between weeks 12 and 48 for those receiving etanercept, and from 15 per cent to 53 percent for those switching from placebo.
It was also shown that the drug was able to improve joint health and reduce levels of inflammation in both cohorts, with the level of improvement between weeks 12 and 48 being more pronounced among those who initially received placebo.
The researchers concluded: "Patients with early active non-radiographic axial spondyloarthritis demonstrated improvement from week 12 in clinical, health, productivity and MRI outcomes that was sustained to 48 weeks."
Etanercept is usually given as a subcutaneous injection once or twice a week. It is currently prescribed in the UK for people with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and juvenile idiopathic arthritis.
Two other anti-TNF therapies, adalimumab (Humira) and golimumab (Simponi), are both already approved for use in non-radiographic axial spondyloarthritis.
A spokesman for Arthritis Research UK, which pioneered and developed anti-TNF therapy for rheumatoid arthritis, welcomed the findings.
"Anti-TNF therapies work well in an increasing number of inflammatory forms of arthritis and continue to transform people's lives,” he added.
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