Combination therapy with anti-TNF agents (etanercept) and chemotherapy drug methotrexate has been shown to be effective in the treatment of Rheumatoid Arthritis. Furthermore, the progression of joint damage has been considerably slowed down in over three quarters of patients. The chronic nature of the severe disabling condition necessitates the need for prevention of long-term joint damage in addition to conventional treatment measures.
ENBREL is the only soluble tumor necrosis factor (TNF) receptor approved to reduce signs and symptoms, induce major clinical response, improve physical function, and inhibit the progression of structural damage in patients with moderately to severely active rheumatoid arthritis (RA). ENBREL can be used alone or in combination with methotrexate.
Tumor necrosis factor (TNF) is a substance that is produced by the immune system. People with different forms of arthritis such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and psoriasis have elevated levels of TNF in their body. The drug ENBREL is designed to block the effect of TNF, thereby enabling treatment.
The drug combination was found to be superior when compared to either of the monotherapy forms. A comparison of the combination therapy, ENBREL monotherapy and methotrexate monotherapy revealed that ENBREL monotherapy had significant results when compared to monotherapy with methotrexate alone.
In addition, the improvement in physical function was significantly higher in the ENBREL combination group than for either therapy alone. The improvement in the health status was 56% in the group of patients treated with combination in comparison to 37 % mean improvement in patients treated with ENBREL alone and 33 % mean improvement in patients treated with methotrexate alone.
Nearly 686 patients were taken up for the study and were randomized into the three categories. Patients received either ENBREL (25 mg twice weekly), methotrexate (up to 20 mg once weekly), or ENBREL (25 mg twice weekly) plus methotrexate once weekly. The patients were assessed radiologically to determine the extent of joint damage. Changes in total erosions, changes in total joint space narrowing, numbers of eroded joints were amongst the various factors assessed. A considerable improvement was noted in the combination group. The tolerability was also much higher.
With more and more studies revealing the different options available for rheumatoid arthritis, choosing the right treatment is simply left to the clinical condition of the patient and the physician's opinion.