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Adenosine deaminase deficiency
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
In a patient with ADA2 deficiency homozygous for p.Arg169Gen stem cell transplantation rescued the immunodeficiency phenotype and may have prevented the development of vasculopathy [34]. He was well at follow up five years later. Some patients had a significant response to treatment with etanercept.
Treatment of Rheumatoid Arthritis
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Stuart Weisman, Arthur Kavanaugh
Etanercept is a bioengineered construct of two p75 TNF receptors attached to the Fc portion of an IgG 1 molecule. It binds to both TNF-α and TNF-β (lymphotoxin-α). Etanercept is administered by subcutaneous injections at a dose of 25 mg twice a week. It has a median half-life of 115 hours.
Retinoids in Psoriasis
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Uwe Wollina, Piotr Brzezinski, André Koch
Biologicals are increasingly used to treat patients with moderate to severe psoriasis. Etanercept is a tumor necrosis factor-alpha receptor antagonist approved for psoriasis and psoriatic arthritis. The combination of acitretin with etanercept may increase the efficacy of treatment (28). A multicenter, randomized, open-label trial assessed the efficacy and safety of acitretin 10 mg twice daily, acitretin plus 25 mg etanercept twice weekly, and etanercept 50 mg twice weekly followed by etanercept 25 mg twice weekly. At week 24, acitretin achieved a PASI50 of 44.4% and a PASI75 of 22.2%, while the combination treatment was superior with PASI50 84.2% and PASI75 57.9%. The etanercept-only group achieved PASI50 and PASI75 of 71.4% and 52.4%. Acitretin add on obviously improved the efficacy of etanercept (40).
Efficacy of an anti-TNF-alpha agent in refractory livedoid vasculopathy: a retrospective analysis
Published in Journal of Dermatological Treatment, 2022
Due to the controversy of first-line treatment of livedoid vasculopathy, its chronic recurrent course, and resistance to current therapy, the reasons why we used etanercept for off-label use in five patients with refractory livedoid vasculopathy are as follows. First, current treatment of livedoid vasculopathy mainly focuses on coagulation pathways. A potential inflammatory response may also be supposed to participate in the pathogenesis of livedoid vasculopathy. On the basis of successful treatment of livedoid vasculopathy with TNF-alpha inhibitors reported in the literature, we carried out a preliminary study on etanercept therapy in patients with refractory livedoid vasculopathy because of its good tolerance and safety. Second, the patients in our study had been treated with steroids, immunosuppressive agents, or danazol for a long time. Complications of the patients included metabolic diseases and menstrual abnormalities. We used etanercept treatment in our patients taking into account any adverse reactions and the desire of the patients themselves.
Anti-inflammatory activities of a new VEGF blocker, Conbercept
Published in Immunopharmacology and Immunotoxicology, 2021
The synovial release of VEGF is stimulated by hypoxia and cell factors such as TNF-α, IL-6, and TGF-β [15]. Previous studies showed that serum VEGF levels could be markedly reduced by Infliximab, a TNFα blocker [29]. Etanercept is a novel receptor decoy drug approved for the treatment of rheumatoid arthritis (RA). It can potently block TNFα activity [30]. In our study, Etanercept significantly inhibited CIA in rats and also reduced serum VEGF, TNFα, and IL-6 levels. Our results showed that inhibition of TNF also reduced the concentrations of VEGF and IL6, and vice versa, indicating that these factors could influence each other in RA. The difference of molecular weight between Conbercept and Etanercept is only 8 KD. According to our results, Conbercept needs almost three times concentrations to achieve the same effect as Etanercept. The difference in the dosage of the two drugs may be caused by the clearance rate and distribution of the drugs in rats, as well as the binding affinity with their ligands. Rheumatoid arthritis (RA) is a complex systemic disease with high expression of many cytokines such as VEGF, TNFα, IL6, etc. Next, we need to study the long-term effect of anti-VEGF drugs, as well as the combined effect of anti-VEGF and anti-TNF drugs.
Real-world utilization of methotrexate or prednisone co-therapy with etanercept among Canadian patients with rheumatoid arthritis: a retrospective cohort study
Published in Current Medical Research and Opinion, 2019
Majed Khraishi, Jelena Ivanovic, Yvonne Zhang, Brad Millson, Marie-Josee Brabant, John Woolcott, Heather Jones, Cinzia Curiale
This study also provides recent estimates of dosing relative to monograph among biologic naïve RA patients newly initiating etanercept, using a validated method of comparison8. In this study, the average patient utilization of etanercept was observed to remain consistent over the first year in the majority of patients. Overall, the average etanercept doses relative to monograph were observed to range from 33.4 mg to 107.3 mg, but only 7–12% of patients exceeded the threshold of ±20% of monograph. Interestingly, the peak average weekly etanercept dose was observed at approximately weeks 8 and 17 post-initiation. These peaks suggest that a clinical correction in treatment occurred. Following week 17, the average weekly doses were consistently lower than monograph. This variability in etanercept dose, both with respect to time since initiation and in average weekly doses, likely reflects patients’ response to treatment. In addition, the lower-than-recommended average weekly doses that were observed after week 17 may suggest that sustained treatment over a 1 year period with a relatively lower dose of etanercept is sufficient to manage some patients.