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Re: Sue (Enbrel)

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I also take Bextra. I couldn't take methotrexate along with the Enbrel

because of a low white blood cell count. I took prednisone along with

methotrexate for a while but got off of it as soon as I could. Still, I

have osteopenia, so I take calcium with D and also Evista. Prednisone

can be very bad for your bones.

Enbrel and Bextra have my RA under control. I count my blessings every

day. I hope that the Enbrel helps you as much as it helps me.

Sue

On Monday, June 28, 2004, at 08:59 PM, renate dorsey wrote:

> I just recently started with Enbrel. Do you not take anything else now

> except the enbrel. I have only had 2 shots but am still taking

> prednisone and methotrexate. I am hoping to do away with both.

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Thank you. I hope so too. I am glad that it works for you. I go to the

rheumy the end of July maybe I can get good news then. Hope you continue to

do well.

Renate

Re: [ ] Sue (Enbrel)

> I also take Bextra. I couldn't take methotrexate along with the Enbrel

> because of a low white blood cell count. I took prednisone along with

> methotrexate for a while but got off of it as soon as I could. Still, I

> have osteopenia, so I take calcium with D and also Evista. Prednisone

> can be very bad for your bones.

>

> Enbrel and Bextra have my RA under control. I count my blessings every

> day. I hope that the Enbrel helps you as much as it helps me.

>

> Sue

>

> On Monday, June 28, 2004, at 08:59 PM, renate dorsey wrote:

>

> > I just recently started with Enbrel. Do you not take anything else now

> > except the enbrel. I have only had 2 shots but am still taking

> > prednisone and methotrexate. I am hoping to do away with both.

>

>

>

>

>

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Renate, you may want to consider keeping the MTX. There is good evidence

that the combination of Enbrel plus MTX works better than either alone.

Here's one recent study:

Lancet. 2004 Feb 28;363(9410):675-81.

Therapeutic effect of the combination of etanercept and methotrexate

compared with each treatment alone in patients with rheumatoid

arthritis: double-blind randomised controlled trial.

Klareskog L, van der Heijde D, de Jager JP, Gough A, Kalden J, Malaise

M, Mola E, Pavelka K, Sany J, Settas L, Wajdula J, Pedersen R,

Fatenejad S, Sanda M; TEMPO (Trial of Etanercept and Methotrexate with

Radiographic Patient Outcomes) study investigators.

Rheumatology Unit, Department of Medicine, Karolinska

Institute/Karolinska Hospital, Stockholm 17176, Sweden.

Lars.Klareskog@...

BACKGROUND: Etanercept and methotrexate are effective in the treatment

of rheumatoid arthritis but no data exist on concurrent initiation or

use of the combination compared with either drug alone. We aimed to

assess combination treatment with etanercept and methotrexate versus the

monotherapies in patients with rheumatoid arthritis. METHODS: In a

double-blind, randomised, clinical efficacy, safety, and radiographic

study, 686 patients with active rheumatoid arthritis were randomly

allocated to treatment with etanercept 25 mg (subcutaneously twice a

week), oral methotrexate (up to 20 mg every week), or the combination.

Clinical response was assessed by criteria of the American College of

Rheumatology (ACR). The primary efficacy endpoint was the numeric index

of the ACR response (ACR-N) area under the curve (AUC) over the first 24

weeks. The primary radiographic endpoint was change from baseline to

week 52 in total joint damage and was assessed with the modified Sharp

score. Analysis was by intention to treat. FINDINGS: Four patients did

not receive any drug; thus 682 were studied. ACR-N AUC at 24 weeks was

greater for the combination group compared with etanercept alone and

methotrexate alone (18.3%-years [95% CI 17.1-19.6] vs 14.7%-years

[13.5-16.0], p<0.0001, and 12.2%-years [11.0-13.4], p<0.0001;

respectively). The mean difference in ACR-N AUC between combination and

methotrexate alone was 6.1 (95% CI 4.5-7.8, p<0.0001) and between

etanercept and methotrexate was 2.5 (0.8-4.2, p=0.0034). The combination

was more efficacious than methotrexate or etanercept alone in

retardation of joint damage (mean total Sharp score -0.54 [95% CI -1.00

to -0.07] vs 2.80 [1.08 to 4.51], p<0.0001, and 0.52 [-0.10 to 1.15],

p=0.0006; respectively). The mean difference in total Sharp score

between combination and methotrexate alone was -3.34 (95% CI -4.86

to -1.81, p<0.0001) and between etanercept and methotrexate was -27

(-3.81 to -0.74, p=0.0469). The number of patients reporting infections

or adverse events was similar in all groups.

INTERPRETATION: The combination of etanercept and methotrexate was

significantly better in reduction of disease activity, improvement of

functional disability, and retardation of radiographic progression

compared with methotrexate or etanercept alone. These findings bring us

closer to achievement of remission and repair of structural damage in

rheumatoid arthritis.

PMID: 15001324

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Sue (Enbrel)

> I just recently started with Enbrel. Do you not take anything else now

except the enbrel. I have only had 2 shots but am still taking

prednisone and methotrexate. I am hoping to do away with both.

>

> Renate

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