No abstract available.
Arthritis, Juvenile* ; Crohn Disease* ; Etanercept

No abstract available.
Immunoglobulin G ; Psoriasis ; Receptors, Tumor Necrosis Factor ; Etanercept

Tumor necrosis factor-alpha (TNF-alpha) inhibitors are increasingly used in treatment of inflammatory disorders because of their immunomodulatory efficacy. Increased risk of infection is an adverse effect of anti-TNF-alpha therapy. The incidence rate and severity of herpes zoster is significantly higher in patients on anti-TNF-alpha therapy than in the general population. The clinical presentation of varicella zoster virus infection is also often atypical in these patients. We experienced a patient who presented with a disseminated varicelliform rash while on etanercept therapy for ankylosing spondylitis.
Exanthema ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Incidence ; Spondylitis, Ankylosing* ; Tumor Necrosis Factor-alpha ; Etanercept

Uveitis is the most common extra-articular manifestation of ankylosing spondylitis, and this occurs in 30~50% of the patients with ankylosing spondylitis. The main symptoms of ankylosing spondylitis are usually highly responsive to TNF inhibitors, but the effects of TNF inhibitors on uveitis are inconsistent. We report here on sixteen cases of new onset uveitis during etanercept therapy in patients with ankylosing spondylitis and they had no histories of uveitis. The symptoms of ankylosing spondyltiis, other than the uveitis, were well controlled during etanercept therapy. Six patients had histories of infliximab therapy before undergoing etanercept therapy, and uveitis did not develop during this infliximab therapy. Uveitis can develop during the course of ankylosing spondylitis, yet there is a possibility of a temporal relationship between etanercept therapy and uveitis.
Antibodies, Monoclonal ; Humans ; Etanercept ; Infliximab ; Immunoglobulin G ; Receptors, Tumor Necrosis Factor ; Spondylitis, Ankylosing ; Uveitis

Advanced knowledges of cellular and molecular biology led to the development of therapies of rheumatoid arthritis (RA). The introduction of biologic agents into clinical practice has had a profound effect on the current management of RA. These agents can rapidly enhance functional status and inhibit the progression of joint damage from the disease. Tumor necrosis factor (TNF) inhibitors are the representative biologic agents for the treatment of RA. Their clinical efficacy and safety were revealed through many clinical trails. Novel TNF inhibitors and other biologic agents for the treatment of RA are developing continuously. Promising biologic agents such as TNF inhibitors have become an important part of treatment armamentarium for RA, although they have some side effects and problems to be solved. These agents may contribute to achieve the sustained remission and eventually cure of RA. Currently available TNF inhibitors in Korea include etanercept, infliximab and adalimumab. This review article introduces past, present, and future of the TNF inhibitors and suggests guidelines for the proper use of them on RA.
Arthritis, Rheumatoid* ; Biological Factors ; Joints ; Korea ; Molecular Biology ; Tumor Necrosis Factor-alpha* ; Adalimumab ; Infliximab ; Etanercept

Sacroiliitis is a rare manifestation in patients with sarcoidosis and there have been several case reports of ankylosing spondylitis (AS) accompanying sarcoidosis. Recently, the development of sarcoidosis has been reported in AS patients treated with tumor necrosis factor blocker. We described a 27-year-old male patient with AS and histologically proven sarcoidosis who was treated with etanercept without aggravation of sarcoidosis.
Adult ; Humans ; Etanercept ; Male ; Sacroiliitis ; Sarcoidosis* ; Spondylitis, Ankylosing* ; Tumor Necrosis Factor-alpha

OBJECTIVE: The purpose of this study is to evaluate the outcome of uveitis in ankylosing spondylitis (AS) during tumor necrosis factor (TNF)-inhibiting therapy and to compare the incidence rate of uveitis in infliximab, adalimumab, and etanercept. METHODS: A retrospective evaluation was performed in AS patients who had started TNF-inhibiting therapy from June 2003 to June 2011. The clinical characteristics of patients with documented uveitis were evaluated. RESULTS: Among 316 patients treated with TNF inhibitor, 26 patients (8%) had experienced uveitis during TNF-inhibiting therapy. Among them, 15 patients were treated with etanercept, eight with adalimumab, and three with infliximab. The overall incidence rate of uveitis flare during therapy with TNF inhibitor was 46 per 1,000 person-years (pys) (95% confidence interval [CI], 32 to 64). The incidence rate did not differ between TNF inhibitors, with 54/1,000 pys (95% CI, 34 to 81) for etanercept, 46/1,000 pys (95% CI, 21 to 87) for adalimumab, and 22/1,000 pys (95% CI, 5 to 64) for infliximab. Fourteen patients experienced a first episode of uveitis. The overall incidence rate of new onset-uveitis after therapy with TNF inhibitor was 19 per 1,000 pys (95% CI, 10 to 31). The incidence rate for etanercept was 24/1,000 pys (95% CI, 12 to 45); adalimumab, 15/1,000 pys (95% CI, 3 to 45); and infliximab, 7/1,000 pys (95% CI, 0 to 40). There was no statistical difference in the incidence of uveitis flare or the cumulative uveitis-free rate among the three TNF inhibitors. CONCLUSION: The relative rate of uveitis, including the first episode, was determined using the TNF inhibitor. However, there was no difference in the incidence rate of uveitis among the three TNF inhibitors.
Humans ; Incidence* ; Korea* ; Retrospective Studies ; Spondylitis, Ankylosing* ; Tumor Necrosis Factor-alpha* ; Uveitis* ; Adalimumab ; Infliximab ; Etanercept

BACKGROUND: Biologic disease-modifying antirheumatic drugs (bDMARDs) extend the treatment choices for rheumatoid arthritis patients with insufficient response or intolerance to conventional DMARDs (cDMARDs). These agents have considerable efficacy compared with conventional DMARDs, but only a few head-to-head comparisons among these agents have been performed. The objective of this systematic review and network meta-analysis (NMA) was to compare the relative efficacy of Certolizumab with conventional DMARD to licensed bDMARD with cDMARD therapy for patients who failed to prior cDMARD treatment under the condition of the reimbursement coverage criteria in Korea. METHODS: A systematic review was conducted using MEDLINE and Cochrane library. Key endpoints were the American College of Rheumatology (ACR) responses of 20/50/70 at six months. Bayesian outcomes were calculated as median of treatment effect, probability of the best, Odds Ratio (OR) and probability that OR was greater than one. RESULTS: Compared with other bDMARDs, Certolizumab were associated with higher or comparable ACR response rates; in ACR20, the OR (probability of OR>1) was 2.08 (92.6%) for Adalimumab, 1.86 (85.7%) for Etanercept, 1.89 (79.5%) for Golimumab, 2.36 (92.1%) for Infliximab, 1.79 (87.0%) for Abatacept, 1.74 (80.8%) for Rituximab and 1.82 (86.8%) for Tocilizaumab. In ACR50 and ACR70, the ORs did not present significant differences. CONCLUSION: Certolizaumab with cDMARD was more effective or comparable than other bDMARDs in patients who failed prior cDMARD treatment.
Antirheumatic Agents* ; Arthritis, Rheumatoid* ; Humans ; Korea ; Odds Ratio ; Rheumatology ; Abatacept ; Adalimumab ; Infliximab ; Rituximab ; Etanercept

BACKGROUND: This study was performed to investigate the efficacy and safety of etanercept in active rheumatoid arthritis patients with stable dose of methotrexate in Korean. METHODS: In a 12 week, single arm, open trial, we assigned 76 patients with active rheumatoid arthritis who had an inadequate response to disease-modifying antirheumatic drugs. Patients received twice-weekly subcutaneous injections of etanercept 25 mg while continuing to receive methotrexate at a stable dose of 7.5~25 mg per week. The clinical response was defined as the percent improvement in disease activity according to the criteria of the American College of Rheumatology (ACR) at 12 weeks. RESULTS: Etanercept led to significant improvements in disease activity and was safe and well tolerated. At 12 week, 84.4% of the patients receiving 25 mg of etanercept achieved a 20% ACR response, and 53.1% of those receiving etanercept achieved a 50% ACR response. The most common adverse event was injection-site reaction. Other adverse events were upper respiratory infection, nausea, and facial edema, but there were no serious adverse events associated with etanercept. CONCLUSION: In active rheumatoid arthritis patients, etanercept was safe, well tolerated, and provided rapid clinical improvements.
Antirheumatic Agents ; Arm ; Arthritis, Rheumatoid* ; Edema ; Humans ; Injections, Subcutaneous ; Methotrexate* ; Nausea ; Rheumatology ; Etanercept

Human ; Male ; Adult ; Etanercept ; Psoriasis ; Receptors, Tumor Necrosis Factor ; Patients ; Adrenal Cortex Hormones ; Phototherapy ; Methotrexate ; Inflammation