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Etanercept Safe, Effective Treatment for Rheumatoid Arthritis in Elderly Patients

For patients over 65 with rheumatoid arthritis, etanercept is a potential treatment option that causes a rapid and sustained response, according to a recent study.

Rheumatoid arthritis (RA) is most prevalent in patients older than 65 years, yet clinical studies on treatments for RA tend to under represent this group in their analyses.

Special attention to the efficacy and safety of arthritis treatments in the elderly is necessary due to medical and health-related differences between the elderly and younger populations, such as increased likelihood of comorbidity, their susceptibility to serious infections and mortality from infections, lack of medication compliance, potential of multiple drug interactions, and decreased tolerability due to physiological changes.

Etanercept is one treatment for RA that is well tolerated and produces significant sustained improvement in disease activity. However, the safety and efficacy of this therapy in patients over 65 has not been properly evaluated. Roy M. Fleischmann, MD, and colleagues conducted a retrospective study, sponsored by Immunex Corporation, Spokane, Washington, to determine the efficacy and safety of etanercept in this patient group.

One hundred and ninety seven of 1,128 patents enrolled in 4 double-blind, randomised trials and 5 open-label etanercept trials were 65 years old or older. All patients had received etanercept subcutaneously twice weekly.

The researchers found that at 3 months of treatment, 55% of patients over age 65 showed 20% improvement in the number of tender and swollen joints and in other American College of Rheumatology (ACR) criteria. After 1 year of treatment, the number of patients with 20% improvement increased to 66% of patients over 65.

Furthermore, etanercept treatment was well tolerated, causing only mild adverse events. In fact, patients in this age group showed a lower rate of injection site reactions, headache, and rhinitis compared to younger patients.

Deaths and cancer diagnoses in patients over 65 treated with etanercept were similar to that estimated for this age group within the general population.

Etanercept "offers older patients with rheumatoid arthritis a rapid, predictable, and sustained clinical response, and is a significant addition to treatment options for these patients," notes Dr. Fleischmann.
J Rheumatol 2003;30:4:691-696. "Response to Etanercept (Enbrel ® ) in Elderly Patients with Rheumatoid Arthritis: A Retrospective Analysis of Clinical Trial Results"

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