 |
|
|
 |
Etanercept (Enbrel®) in Patients with Rheumatoid Arthritis with Recent Onset Versus Established Disease: Improvement in Disability
SCOTT W. BAUMGARTNER, ROY M. FLEISCHMANN, LARRY W. MORELAND, MICHAEL H. SCHIFF, JOSEPH MARKENSON, and JAMES B. WHITMORE
ABSTRACT. Methods. Health Assessment Questionnaire (HAQ) scores were collected over 3 years in 2 groups of patients with RA who were treated with etanercept. The first group consisted of 207 patients with recent onset RA (mean duration of 1 year) who had not previously received methotrexate, and the second group consisted of 464 patients with established RA (mean duration of 12 years) who had failed one or more disease-modifying antirheumatic drugs. Results. Baseline demographics and disease characteristics were similar in the 2 groups, except for HAQ scores and C-reactive protein levels, which were higher in the established RA group. Patients in both groups showed rapid and sustained clinical responses with etanercept therapy, but patients with recent onset RA showed significantly greater improvement in HAQ scores compared with patients with established RA. The difference in magnitude of HAQ score improvement between groups was observed as early as week 2 after initiation of etanercept and persisted throughout the 3-year time frame. At year 3, significantly more patients with recent onset RA had a HAQ score of zero (26%) versus those with established RA (14%, p = 0.0095). Conclusion. Although etanercept therapy significantly improved disability scores in both groups, patients with recent onset of RA showed greater benefit in HAQ scores than patients with established RA. These results support prompt treatment of RA at an early stage of disease to minimize patient disability. (J Rheumatol 2004;31:1532-7) Key Indexing Terms:
RHEUMATOID ARTHRITIS
Physician's Clinic of Spokane, Spokane, Washington; Radiant Research, Dallas, Texas; University of Alabama at Birmingham, Birmingham Alabama; Denver Arthritis Clinic, Denver, Colorado; Hospital for Special Surgery, New York, New York; Amgen, Inc., Thousand Oaks, California, USA. Supported by Immunex Corporation, a wholly-owned subsidiary of Amgen, Inc., Thousand Oaks, CA (study drug and grants to investigational sites). S.W. Baumgartner, MD, Physician's Clinic of Spokane; R.M. Fleischmann, MD, Radiant Research; L.W. Moreland, MD, University of Alabama at Birmingham; M.H. Schiff, MD, Denver Arthritis Clinic; J. Markenson, MD, Hospital for Special Surgery; J.B. Whitmore, PhD, Amgen, Inc. Address reprint requests to Dr. S.W. Baumgartner, Physician's Clinic of Spokane, 820 S McClellan Street, Suite 200, Spokane, WA 99204, USA. E-mail: sbaumg@physicians-clinic.com Submitted March 24, 2003; revision accepted February 4, 2004. |