Etanercept and methotrexate combination therapy

Tumor necrosis factor (TNF) is a major proinflammatory cytokine in the rheu matoid joint. TNF activity can be neutralized by administration of a recomb inant version of its soluble p75 TNF receptor linked to the Fc portion of h uman immunoglobulin IgG1 (etanercept). The present study examined the combi nation of etanercept with methotrexate (MTX) in a group of patients with rh eumatoid arthritis (RA) who had persistent activity despite monotherapy wit h MTX. The etanercept-MTX group had a significantly better outcome than the placebo MTX group using American College of Rheumatology (ACR) criteria. A t 6 months, 71% of the patients in the etanercept-MIX group had an ACR 20% response (versus 27% in the placebo-MTX group). In the etanercept-MTX group , 39% had an ACR 50% response (versus 3% in the placebo-MIX group), and 15% in the etanercept-MIX group versus 0% in the placebo-MIX group met the rob ust ACR 70% response. The present study indicates that etanercept is a nove l and robust drug in combination with MTX for the treatment of RA.