Enbrel in patients with RA with recent onset versus established disease: improvement in disability

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J Rheumatol. 2004 Aug;31(8):1532-7.

Etanercept (enbrel®) in patients with rheumatoid arthritis with recent

onset versus established disease: improvement in disability.

Baumgartner SW, Fleischmann RM, Moreland LW, Schiff MH, Markenson J,

Whitmore JB.

Physician's Clinic of Spokane, Spokane, Washington, USA.

OBJECTIVE: To compare etanercept-induced improvement in disability of

patients with recent onset of rheumatoid arthritis (RA) to that of

patients with established RA. METHODS: Health Assessment Questionnaire

(HAQ) scores were collected over 3 years in 2 groups of patients with RA

who were treated with etanercept. The first group consisted of 207

patients with recent onset RA (mean duration of 1 year) who had not

previously received methotrexate, and the second group consisted of 464

patients with established RA (mean duration of 12 years) who had failed

one or more disease-modifying antirheumatic drugs. RESULTS: Baseline

demographics and disease characteristics were similar in the 2 groups,

except for HAQ scores and C-reactive protein levels, which were higher

in the established RA group. Patients in both groups showed rapid and

sustained clinical responses with etanercept therapy, but patients with

recent onset RA showed significantly greater improvement in HAQ scores

compared with patients with established RA. The difference in magnitude

of HAQ score improvement between groups was observed as early as week 2

after initiation of etanercept and persisted throughout the 3-year time

frame. At year 3, significantly more patients with recent onset RA had a

HAQ score of zero (26%) versus those with established RA (14%, p =

0.0095).

CONCLUSION: Although etanercept therapy significantly improved

disability scores in both groups, patients with recent onset of RA

showed greater benefit in HAQ scores than patients with established RA.

These results support prompt treatment of RA at an early stage of

disease to minimize patient disability.

PMID: 15290731

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