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Better short-term clinical response to etanercept in Chinese than Caucasian patients with active ankylosing spondylitis

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Modern Rheumatology

Abstract

Tumor necrosis factor-alpha (TNF-α) inhibitors including etanercept have been demonstrated to be very effective in severe ankylosing spondylitis (AS) in Caucasian patients. However, clinical efficacy of etanercept to treat active AS in Chinese patients has not been reported. In this study, a prospective, open-label trial of etanercept (25 mg BIW), involving 46 AS patients from 16 medical centers of Taiwan, was conducted. Questionnaire was utilized to record demographic data and clinical parameters, including Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Global Index (BASGI), Assessment in Ankylosing Spondylitis (ASAS) 20, 50, and 70, and others, before and at different time intervals after etanercept treatment. Laboratory tests including blood chemistry, hematology, urine analysis, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were done at baseline and at weeks 4, 8, and 12. In this 12-week study, etanercept demonstrated rapid and significant improvement in the ASAS20 response criteria (91.3%), at as early as 2 weeks of therapy (71.3%). Partial remission of AS was achieved in 49.3% of patients after 12 weeks of treatment. Disease activity (BASDAI) and function (BASFI) were also significantly improved after 12 weeks etanercept treatment (p < 0.0001 and p < 0.0001, respectively). In addition, significant increase of chest expansion (2.77 ± 1.69 cm versus 3.56 ± 1.82 cm, p = 0.0004) and lumbar flexion (2.11 ± 2.76 cm versus 2.58 ± 3.42 cm, p = 0.0075) and significant reduction of occiput-to-wall distance (6.59 ± 7.14 cm versus 5.32 ± 6.65 cm, p = 0.0006) were also demonstrated. Both ESR and CRP declined significantly after patients were treated with etanercept. There were no severe adverse effects during the treatment period. Etanercept is generally safe, well tolerated, and effective in Chinese patients with severe AS. Clinical efficacy, including partial remission and BASDAI, is even better in Chinese than in Caucasian patients. Further study is required to assess long-term efficacy and safety in Chinese patients with AS.

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Acknowledgments

Thanks are due to Wyeth Company, which provided us with etanercept samples for this open-label, postmarketing clinical trial.

Conflict of interest statement

None.

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Authors and Affiliations

  1. Division of Allergy-Immunology-Rheumatology, Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Shih-Pai, Taipei, 11217, Taiwan

    Chung-Tei Chou & Chang-Youh Tsai

  2. Division of Rheumatology, Municipal Wan Fang Hospital, Taipei, Taiwan

    Tung-Hua Liang

  3. Division of Rheumatology, Tri-Service General Hospital, Taipei, Taiwan

    Te-Ming Chang & Chen-Hung Lai

  4. Division of Allergy-Immunology-Rheumatology, Chung Shan Medical University, Taichung, Taiwan

    Cheng-Chung Wei

  5. Division of Rheumatology and Immunology, Cathay General Hospital, Taipei, Taiwan

    Kun-Hung Chen & Shih-Chang Lin

  6. Division of Allergy-Immunology-Rheumatology, National Taiwan University Hospital, Taipei, Taiwan

    Chia-Li Yu

  7. Division of Rheumatology, Chang-Gung Memorial Hospital, Taipei, Linkou, Taiwan

    Lieh-Bang Liou & Shue-Fen Luo

  8. Division of Rheumatology, Mackay Memorial Hospital, Taipei, Taiwan

    Chyou-Shen Lee

  9. Division of Rheumatology, Christian Hospital, Changhua, Taiwan

    Yin-Tzu Hsue

  10. Division of Rheumatology, China Medical University Hospital, Taichung, Taiwan

    Chung-Ming Huang & Jiunn-Hong Chen

  11. Division of Rheumatology, Buddhist Tzu Chi General Hospital, Dalin, Taiwan

    Ning-Sheng Lai

  12. Division of Rheumatology, Chi Mei Medical Center, Tainan, Taiwan

    He-Hsiung Cheng

  13. Division of Rheumatology, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan

    Tien-Tsai Cheng & Han-Ming Lai

  14. Division of Rheumatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Wen-Chan Tsai & Jeng-Hsien Yen

  15. Division of Rheumatology, Veterans General Hospital, Kaohsiung, Taiwan

    Ling-Ying Lu

  16. Division of Rheumatology, Sho Chwan Memorial Hospital, Changhua, Taiwan

    Chung-Pei Chang

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  1. Chung-Tei Chou
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Correspondence to Chung-Tei Chou.

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Chou, CT., Tsai, CY., Liang, TH. et al. Better short-term clinical response to etanercept in Chinese than Caucasian patients with active ankylosing spondylitis. Mod Rheumatol 20, 580–587 (2010). https://doi.org/10.1007/s10165-010-0334-2

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