Etanercept reduces spinal inflammation

Recent findings indicate that etanercept reduces active spinal inflammation in patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (uSpA).Eighteen patients with active AS and seven with active uSpA who participated in a recent clinical trial with etanercept were investigated by MRI of the spine or the SI joints, or both. The initial trial included 40 patients from two sites (Berlin and Herne, Germany). At baseline, 30 patients with AS were randomly allocated to either etanercept (n = 14) or placebo (n = 16), whereas all 10 patients with uSpA were treated with etanercept.Professor Braun's team report that patients treated with etanercept showed improvements in MRI spinal inflammatory scores from a mean of 11.2 to 6.8 after six weeks, whereas placebo patients experienced no significant change. There was no significant difference in the level of improvement between patients with AS or uSpA.Depending on the method used to measure inflammation the authors identify that by 24 weeks mean reductions in active spinal inflammation ranged from 56.3% to 69.5%. However, there were no significant improvements in chronic spinal changes, the researchers note.The authors add that regardless of scoring system used, MRI revealed no significant changes in the sacroiliac joints with etanercept treatment, although there was a slight, non-significant decline in active inflammatory lesions at 24 weeks.In a related publication Professor Braun comments, "Using MRI we have now objective evidence that spinal inflammation is reduced, and we hope that this is also true for radiographic damage."The authors conclude that etanercept can reduce active inflammatory lesions of the spine in patients with active AS and uSpA and call for further investigation into the role of etanercept on deceleration of chronic spinal changes.Reference...