Arthritis News – 1999

In a recently published study, Weinblatt, etal (N Engl J Med 340:253) demonstrate that the combination of etanercept and methotrexate, compared to methotrexate alone, significantly improves disease activity in Rheumatoid Arthritis (RA) patients.

The study involved 89 patients with active RA who had been taking methotrexate for at least the previous six months and were at a stable dose of 15 to 25mg per week for the last 4 weeks (10mg for those unable to tolerate higher doses). Of 57 patients who received methotrexate and etanercept in this 24-week, double blind study, 71% met the American College of Rheumatology 20% improvement criteria (Definition of Improvement in RA trials) in measures of disease activity, as compared to 29% of the 30 patients receiving methotrexate plus placebo. By 24 weeks, 39% of the methotrexate plus etanercept met the ACR 50 criteria compared with 3% in the methotrexate plus placebo group.

The combination of etanercept and methotrexate provides an alternative for those patients with active RA who have failed to have adequate response to methotrexate alone. The unanswered question is how well this combination would compare to entanercept alone.