Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
November-2014 Volume 8 Issue 5

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
November-2014 Volume 8 Issue 5

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article

Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis

  • Authors:
    • Ya-Fei Liu
    • Hui Dong
    • Sheng-Hao Tu
    • Cui-Hong Zheng
    • Pei-Lin Liu
    • Yong-Hong Hu
  • View Affiliations / Copyright

    Affiliations: Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
  • Pages: 1585-1592
    |
    Published online on: September 17, 2014
       https://doi.org/10.3892/etm.2014.1974
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

Etanercept (ETN) has been widely applied in the treatment of ankylosing spondylitis (AS). As the use of ETN has increased, associated adverse effects have been reported frequently. Previous meta‑analyses have focused on comparing the differences in clinical outcomes between ETN and placebo (PBO). The present meta‑analysis evaluated randomised controlled trials (RCTs) to compare the effects of ETN and a PBO or sulfasalazine (SSZ) in patients with AS. The study population characteristics and the main results, including the Assessment in AS 20% response (ASAS 20), the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI), were extracted. The pooled odds ratios (ORs) or weighted mean differences (MDs) were calculated using a fixed or random effects model. Fifteen randomised controlled trials (RCTs) involving 2,194 subjects were included. Compared with a PBO, ETN significantly improved the ASAS 20 [P<0.00001; OR, 8.25; 95% confidence interval (CI), 5.92‑11.50], BASDAI (P<0.00001; MD, -18.81; 95% CI, -24.47 to -13.15) and BASFI (P<0.00001; standard MD, -0.68; 95% CI, -0.85 to -0.50). In comparison with SSZ, ETN significantly decreased the BASDAI (P<0.00001; MD, -2.40; 95% CI, -2.89 to -1.90) and C-reactive protein (CRP) levels (P<0.0001; MD, -8.01; 95% CI, -11.73 to -4.29). The most common adverse effect of ETN was an injection site reaction. This meta‑analysis shows that ETN monotherapy is effective in improving physical function and reducing disease activity in patients with AS. Compared with SSZ, ETN markedly decreased the BASDAI and CRP levels. However, the efficacy of ETN in treating AS requires further evaluation by more RCTs in a larger population of patients prior to recommending ETN as a substitute for synthetic disease‑modifying antirheumatic drug (DMARD) monotherapy, or combinations of synthetic DMARDs.
View Figures

Figure 1

Figure 2

Figure 3

Figure 4

View References

1 

Braun J and Sieper J: Ankylosing spondylitis. Lancet. 369:1379–1390. 2007. View Article : Google Scholar

2 

Feldtkeller E, Khan M, van der Heijde D, et al: Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis. Rheumatol Int. 23:61–66. 2003.PubMed/NCBI

3 

Sieper J and Braun J: Anti-TNF agents for the treatment of spondyloarthropathies. Expert Opin Emerg Drugs. 7:235–246. 2002. View Article : Google Scholar : PubMed/NCBI

4 

Gratacos J, Collado A, Filella X, et al: Serum cytokines (IL-6, TNF-α, IL-1β and IFN-γ) in ankylosing spondylitis: a close correlation between serum IL-6 and disease activity and severity. Rheumatology. 33:927–931. 1994.

5 

Braun J, Bollow M, Neure L, et al: Use of immunohistologic and in situ hybridization techniques in the examination of sacroiliac joint biopsy specimens from patients with ankylosing spondylitis. Arthritis Rheum. 38:499–505. 1995. View Article : Google Scholar : PubMed/NCBI

6 

Culy CR and Keating GM: Etanercept: an updated review of its use in rheumatoid arthritis, psoriatic arthritis and juvenile rheumatoid arthritis. Drugs. 62:2493–2537. 2002.PubMed/NCBI

7 

Mease PJ, Goffe BS, Metz J, et al: Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet. 356:385–390. 2000. View Article : Google Scholar : PubMed/NCBI

8 

Lovell DJ, Giannini EH, Reiff A, et al: Etanercept in children with polyarticular juvenile rheumatoid arthritis. N Engl J Med. 342:763–769. 2000. View Article : Google Scholar : PubMed/NCBI

9 

Braun J, Van den Berg R, Baraliakos X, et al: 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 70:896–904. 2011. View Article : Google Scholar : PubMed/NCBI

10 

Chen J and Liu C: Sulfasalazine for ankylosing spondylitis. Cochrane Database Syst Rev. 18:CD0048002005.

11 

Ferraz MB, Tugwell P, Goldsmith CH, et al: Meta-analysis of sulfasalazine in ankylosing spondylitis. J Rheumatol. 17:1482–1486. 1990.PubMed/NCBI

12 

Li SH, Ma B, Tan JY, et al: Efficacy and safety of etanercept for patients with ankylosing spondylitis: a systematic review. Chinese Journal of Evidence-Based Medicine. 9:423–429. 2009.(In Chinese).

13 

Moher D, Liberati A, Tetzlaff J and Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 151:264–269. 2009. View Article : Google Scholar

14 

van der Linden S, Valkenburg HA and Cats A: Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 27:361–368. 1984.

15 

Jadad AR, Moore RA, Carroll D, et al: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 17:1–12. 1996. View Article : Google Scholar

16 

Anderson JJ, Baron G, van der Heijde D, et al: Ankylosing spondylitis assessment group preliminary definition of short-term improvement in ankylosing spondylitis. Arthritis Rheum. 44:1876–1886. 2001. View Article : Google Scholar : PubMed/NCBI

17 

Garrett S, Jenkinson T, Kennedy LG, et al: A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 21:2286–2291. 1994.PubMed/NCBI

18 

Calin A, Garrett S, Whitelock H, et al: A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol. 21:2281–2285. 1994.PubMed/NCBI

19 

Dougados M, Braun J, Szanto S, et al: Efficacy of etanercept on rheumatic signs and pulmonary function tests in advanced ankylosing spondylitis: results of a randomised double-blind placebo-controlled study (SPINE). Ann Rheum Dis. 70:799–804. 2011. View Article : Google Scholar

20 

Lin Q, Lin Z, Gu J, et al: Abnormal high-expression of CD154 on T lymphocytes of ankylosing spondylitis patients is down-regulated by etanercept treatment. Rheumatol Int. 30:317–323. 2010. View Article : Google Scholar : PubMed/NCBI

21 

Gorman JD, Sack KE and Davis JC Jr: Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor α. N Engl J Med. 346:1349–1356. 2002.

22 

Davis JC Jr, Van Der Heijde D, Braun J, et al; Enbrel Ankylosing Spondylitis Study Group. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis: a randomized, controlled trial. Arthritis Rheum. 48:3230–3236. 2003. View Article : Google Scholar

23 

Braun J, van der Horst-Bruinsma IE, Huang F, et al: Clinical efficacy and safety of etanercept versus sulfasalazine in patients with ankylosing spondylitis: A randomized, double-blind trial. Arthritis Rheum. 63:1543–1551. 2011. View Article : Google Scholar : PubMed/NCBI

24 

Calin A, Dijkmans BAC, Emery P, et al: Outcomes of a multicentre randomised clinical trial of etanercept to treat ankylosing spondylitis. Ann Rheum Dis. 63:1594–1600. 2004. View Article : Google Scholar : PubMed/NCBI

25 

van der Heijde D, Da Silva JC, Dougados M, et al; Etanercept Study 314 Investigators. Etanercept 50 mg once weekly is as effective as 25 mg twice weekly in patients with ankylosing spondylitis. Ann Rheum Dis. 65:1572–1577. 2006.PubMed/NCBI

26 

Brandt J, Khariouzov A, Listing J, et al: Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum. 48:1667–1675. 2003. View Article : Google Scholar : PubMed/NCBI

27 

Huang F, Zhang J, Zheng Y, et al: A multicenter, double-blind, randomized, placebo-controlled clinical trial of etanercept in the treatment of Chinese patients with active ankylosing spondylitis. Zhonghua Nei Ke Za Zhi. 50:1043–1047. 2011.(In Chinese).

28 

Huang F, Zhang J, Huang JL, et al: A multicenter, double-blind, placebo-controlled, randomized clinical study of etanercept in the treatment of ankylosing spondylitis. Zhonghua Nei Ke Za Zhi. 49:741–745. 2010.(In Chinese).

29 

Deng XH, Hang F, Zhang YM, et al: Treatment of ankylosing spondylitis with recombinant human tumor necrosis factor-Fc fusion protein (etanercept): a multicenter, randomized, double-blind, placebo-controlled trial. Jun Yi Jin Xiu Xue Yuan Xue Bao. 30:21–23. 2009.(In Chinese).

30 

Zhang J, Zhang YM, Zhang JL, et al: Efficacy of etanercept in patients with ankylosing spondylitis: A double-blind, randomized, placebo controlled trial. Zhongguo Xin Yao Za Zhi. 18:1846–1849. 2009.(In Chinese).

31 

Zhao WM, Chen ZW and Wang MJ: Clinical observation of etanercept in treatment of ankylosing spondylitis. Suzhou Da Xue Xue Bao. 29:518–523. 2009.(In Chinese).

32 

Zhao FT, Zhao H and Wang YL: Efficacy of etanercept on ankylosing spondylitis. Shanghai Jiaotong Daxue Xuebao Yixueban. 29:1506–1508. 2009.(In Chinese).

33 

Sterne JA, Gavaghan D and Egger M: Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J Clin Epidemiol. 53:1119–1129. 2000. View Article : Google Scholar : PubMed/NCBI

34 

Davis JC Jr: The role of etanercept in ankylosing spondylitis. Clin Exp Rheumatol. 20(Suppl 28): S111–S115. 2002.PubMed/NCBI

35 

Chen MZ, Zhao RGT, Wang HY, et al: Clinical control study of recombinant human tumor necrosis factor-Fc fusion protein and traditional immunity depressant in treatment of ankylosing spondylitis (AS). Xinjiang Yi Ke Da Xue Xue Bao. 33:913–915. 2010.(In Chinese).

36 

Machado MA, Barbosa MM, Almeida AM, et al: Treatment of ankylosing spondylitis with TNF blockers: a meta-analysis. Rheumatol Int. 33:2199–2213. 2013. View Article : Google Scholar : PubMed/NCBI

37 

Li ZH, Zhang Y, Wang J and Shi ZJ: Etanercept in the treatment of ankylosing spondylitis: a meta-analysis of randomized, double-blind, placebo-controlled clinical trials, and the comparison of the Caucasian and Chinese population. Eur J Orthop Surg Traumatol. 23:497–506. 2013. View Article : Google Scholar : PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Liu Y, Dong H, Tu S, Zheng C, Liu P and Hu Y: Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis. Exp Ther Med 8: 1585-1592, 2014.
APA
Liu, Y., Dong, H., Tu, S., Zheng, C., Liu, P., & Hu, Y. (2014). Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis. Experimental and Therapeutic Medicine, 8, 1585-1592. https://doi.org/10.3892/etm.2014.1974
MLA
Liu, Y., Dong, H., Tu, S., Zheng, C., Liu, P., Hu, Y."Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis". Experimental and Therapeutic Medicine 8.5 (2014): 1585-1592.
Chicago
Liu, Y., Dong, H., Tu, S., Zheng, C., Liu, P., Hu, Y."Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis". Experimental and Therapeutic Medicine 8, no. 5 (2014): 1585-1592. https://doi.org/10.3892/etm.2014.1974
Copy and paste a formatted citation
x
Spandidos Publications style
Liu Y, Dong H, Tu S, Zheng C, Liu P and Hu Y: Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis. Exp Ther Med 8: 1585-1592, 2014.
APA
Liu, Y., Dong, H., Tu, S., Zheng, C., Liu, P., & Hu, Y. (2014). Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis. Experimental and Therapeutic Medicine, 8, 1585-1592. https://doi.org/10.3892/etm.2014.1974
MLA
Liu, Y., Dong, H., Tu, S., Zheng, C., Liu, P., Hu, Y."Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis". Experimental and Therapeutic Medicine 8.5 (2014): 1585-1592.
Chicago
Liu, Y., Dong, H., Tu, S., Zheng, C., Liu, P., Hu, Y."Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis". Experimental and Therapeutic Medicine 8, no. 5 (2014): 1585-1592. https://doi.org/10.3892/etm.2014.1974
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team