Efficacy and safety of etanercept in chronic immune-mediated disease

Giuseppe Murdaca, Francesca Spanò, Miriam Contatore, Andrea Guastalla, Ottavia Magnani, Francesco Puppo

Research output: Contribution to journalArticlepeer-review


Introduction: TNF-α inhibitors have demonstrated efficacy in large, randomized controlled clinical trials either as monotherapy or in combination with other anti-inflammatory or disease-modifying antirheumatic drugs in the treatment of chronic inflammatory immune-mediated diseases. Etanercept is a fusion protein that acts as a 'decoy receptor' for TNF-α. Areas covered: This paper evaluates the efficacy and safety of etanercept in patients with chronic inflammatory immune-mediated diseases. Expert opinion: Etanercept was first approved for the treatment of rheumatoid arthritis (RA) and subsequently of chronic plaque psoriasis, psoriatic arthritis, ankylosing spondylitis and juvenile RA. Etanercept as other TNF-α inhibitors, particularly infliximab, may be administered off-label to treat other chronic inflammatory immune-mediated diseases such as systemic sclerosis, Behcet disease, systemic lupus erythematosus, polymyositis, dermatomyositis and mixed connective tissue disease. Early etanercept treatment prevents joint damage and helps to avoid long-term disability in arthritis. Etanercept administered at a dose of 50 mg once weekly is effective in inducing an earlier remission of RA, and etanercept 50 mg twice weekly may favor a more rapid improvement of psoriasis and psoriatic arthritis. Etanercept and adalimumab may exert beneficial effects on lipid profile and improve endothelial dysfunction. Appropriate screening tests for latent tuberculosis, hepatitis B virus and hepatitis C virus should be performed before starting etanercept. TNF-α inhibitors including etanercept are contraindicated in patients with demyelinating diseases.

Original languageEnglish
Pages (from-to)649-661
Number of pages13
JournalExpert Opinion on Drug Safety
Issue number5
Publication statusPublished - 2014


  • Etanercept
  • Hepatitis B virus
  • Hepatitis C virus
  • Immune-mediated diseases
  • Tuberculosis

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)


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