Clinical and laboratory improvement in ankylosing spondylitis after treatment with etanercept - A case report

A patient with ankylosing spondylitis involving the back, feet, ankles, kne es, wrists, hands, and elbows exhibited intolerance or inadequate response to multiple prior therapies. Because of the potential role of tumor necrosi s factor in the pathogenesis of AS, the tumor necrosis factor antagonist et anercept (Enbrel) 25 mg was given s.c. twice weekly. Beginning 2 weeks afte r the initiation of etanercept, the patient noted symptomatic improvement i n axial and peripheral joints. The patient experienced resolution of mornin g stiffness and near complete resolution of fatigue. Marked improvement in hemoglobin and erythrocyte sedimentation rate was also seen, although knee joint fluid leukocytes did not change appreciably. This response is encoura ging, especially because both axial symptoms and peripheral disease respond ed to treatment, in contrast to what has been previously reported for sulfa salazine. Further study of etanercept in ankylosing spondylitis is warrante d.