The clinical efficacy and safety of short-term combination therapy with etanercept, methotrexate and cyclophosphamide for rheumatoid arthritis / 中华风湿病学杂志

Objective To study the efficiency and safety of short-term combination therapy with e-tanercept, methotrexate and eyclophosphamide in the patients with active rheumatoid arthritis. Methods Eighty-four patients with rheumatoid arthritis were included into this study. However, only fifty-six patients were treated with either twice-weekly subcutaneous etanercept, weekly oral MTX and CTX injection every three weeks or twice-weekly subcutaneous etanercept only. The American College of Rheumamatology (ACR) criteria for improvement was used for clinical efficacy assessment and the following laboratory papameters were analyzed:blood routine test, ESR, liver enzymes and renal function parameters, RF and anti-CCP antibody at baseline and the 2,4,8,12,24,36,52 weeks .At the same time ,all the adverse events were monitored throughout the study. Results The improvement of patients who received etanercept shortly, MTX and CTX periodically was as rapid as that of the patients who only received etanercept in ACR20, ACRYO, ESR and CRP (P>0.05). At the end of 36 weeks treatment, the level of anti-CCP antibody in the control group was higher than that of the test group. There was no significant difference between the two groups in adverse events (P<0.05). Conclusion The efficacy and safety of treatment with etanercept, methotrexate and cyclophosphamide in the patients with active rheumatoid arthritis is good.

Etanercept treatment decreases peripheral T cell reactivity and increases dendritic cell number of ankylosing spondylitis patients / 中华风湿病学杂志

Objective To study the effect of TNF-α antagonist (etanercept) treatment on the peripheral T cell reactivity of ankylosing spondylitis (AS) patients. Methods Peripheral blood mononuclear cells (PBMC) were collected from 40 patients with AS at baseline, after two and six weeks of etanercept treatment or placebo and from healthy controls. The number of cells that secret TNF-α,IL-2 and IFN-γwas respectively detected by ELISPOT. CD+/CD8+ T cell proliferation was assayed with WST-1 live cell staining method. Results After 2 and 6 weeks of etanercept treatment, the number of TNF-α secreting monocytes was decreased. Although the T cell proliferation rate was not reduced, the number of T cells secreting IL-2 and IFN-γ under anti-CD3/anti-CD28 stimulation was significantly decreased. Conclusion The anti-TNF-α therapy suppresses the functions of effector T cells. The reduced T cell reactivity may contribute to the efficacy of the TNF-α antagonist therapy in AS patients.