PMID- 28756532
OWN - NLM
STAT- MEDLINE
DCOM- 20180719
LR  - 20220331
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 36
IP  - 9
DP  - 2017 Sep
TI  - Etanercept is effective as monotherapy or in combination with methotrexate in 
      rheumatoid arthritis: subanalysis of an observational study.
PG  - 1989-1996
LID - 10.1007/s10067-017-3757-8 [doi]
AB  - Approximately 30% of patients with rheumatoid arthritis receiving biological 
      disease-modifying antirheumatic drugs (bDMARDs) take them as monotherapy. 
      Although etanercept (ETN) monotherapy has been evaluated in clinical trials, data 
      in the real-world setting are sparse. We compared the efficacy and safety of ETN, 
      given alone or in combination with methotrexate (MTX), in routine clinical 
      practice. This was a subanalysis of patients who received either ETN alone or 
      ETN + MTX during a 52-week prospective, observational study conducted at 329 
      German centers. The primary endpoint was "Funktionsfragebogen Hannover" (Hannover 
      Functional Ability Questionnaire [FFbH]; low FFbH = worse function) functional 
      remission at week 26 and week 52. Secondary endpoints included the 28-joint count 
      Disease Activity Score (DAS28), DAS28 remission (DAS28 < 2.6), and adverse events 
      (AEs). Participating centers applied ETN monotherapy in 43.1% of patients and 
      ETN + MTX in 56.9%. A smaller proportion of patients achieved FFbH functional 
      remission with ETN vs ETN + MTX (31.9%, 95% confidence interval [CI] 29.1-34.9% 
      vs 39.8%, 37.2-42.5%, respectively; p < 0.001) at 26 weeks and at 52 weeks 
      (38.4%, 35.1-41.7% vs 44.3%, 41.5-47.2%, respectively; p = 0.007). After 
      52 weeks, the mean DAS28 (+/-SD) decreased from 5.5 +/- 1.3 to 3.4 +/- 1.4 (ETN) vs 
      5.3 +/- 1.3 to 3.2 +/- 1.3 (ETN + MTX) and DAS28 remission was achieved by 32.5% (95% 
      CI 29.0-36.1%) of patients with ETN vs 38.8% (35.8-41.9%; p = 0.007) with 
      ETN + MTX. Overall, 20.6 (ETN) and 19.7% (ETN + MTX) of patients reported 
      treatment-related AEs. Patients received ETN monotherapy almost as often as 
      ETN + MTX. ETN + MTX appeared marginally more effective than ETN monotherapy in 
      some, but not all, outcomes measured.
FAU - Gaubitz, Markus
AU  - Gaubitz M
AD  - Interdisziplinare Diagnostik und Therapie, Akademie fur Manuelle Medizin an der 
      WWU Munster, Von-Esmarch-Str. 50, 48149, Munster, Germany. 
      gaubitz@uni-muenster.de.
FAU - Gottl, Karl-Heinz
AU  - Gottl KH
AD  - Gemeinschaftspraxis, Passau, Germany.
FAU - Behmer, Olaf
AU  - Behmer O
AD  - Pfizer Pharma GmbH, Berlin, Germany.
FAU - Lippe, Ralph
AU  - Lippe R
AD  - Pfizer Pharma GmbH, Berlin, Germany.
FAU - Meng, Thomas
AU  - Meng T
AD  - Pfizer Pharma GmbH, Berlin, Germany.
FAU - Loschmann, Peter-Andreas
AU  - Loschmann PA
AD  - Pfizer Pharma GmbH, Berlin, Germany.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20170730
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - OP401G7OJC (Etanercept)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Drug Therapy, Combination
MH  - Etanercept/*therapeutic use
MH  - Female
MH  - Germany
MH  - Humans
MH  - Male
MH  - Methotrexate/*therapeutic use
MH  - Middle Aged
MH  - Prospective Studies
MH  - Receptors, Tumor Necrosis Factor/antagonists & inhibitors
MH  - Remission Induction
MH  - Severity of Illness Index
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Etanercept
OT  - Methotrexate
OT  - Observational study
OT  - Rheumatoid arthritis
OT  - Tumor necrosis factor-alpha
EDAT- 2017/08/02 06:00
MHDA- 2018/07/20 06:00
CRDT- 2017/07/31 06:00
PHST- 2017/04/28 00:00 [received]
PHST- 2017/07/07 00:00 [accepted]
PHST- 2017/07/04 00:00 [revised]
PHST- 2017/08/02 06:00 [pubmed]
PHST- 2018/07/20 06:00 [medline]
PHST- 2017/07/31 06:00 [entrez]
AID - 10.1007/s10067-017-3757-8 [pii]
AID - 10.1007/s10067-017-3757-8 [doi]
PST - ppublish
SO  - Clin Rheumatol. 2017 Sep;36(9):1989-1996. doi: 10.1007/s10067-017-3757-8. Epub 
      2017 Jul 30.