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Etanercept May Be a Treatment Option for Dermatomyositis

Etanercept has steroid-sparing effect with average time to treatment failure of 358 days

TUESDAY, June 21 (HealthDay News) -- Etanercept appears safe with a steroid sparing effect in the treatment of dermatomyositis, according to a study published online June 17 in the Annals of Neurology.

Anthony A. Amato, M.D., from the Brigham and Women's Hospital in Boston, and colleagues from the Muscle Study Group investigated the safety and tolerability of etanercept, and the feasibility and safety of forced prednisone taper in a pilot study of 16 patients with dermatomyositis. A total of 11 participants were randomized to receive 50 mg etanercept weekly, and five to receive placebo, for 52 weeks. Prednisone was tapered off over the initial 24 weeks. Adverse events, time from randomization to treatment failure, and average prednisone dosage after week 24 were estimated along with other outcome measures recommended by the International Myositis Assessment Clinical Study (IMACS) group.

The investigators found that the treatment groups showed no significant differences in adverse event rates except for a worsened rash in one placebo-treated patient and five etanercept-treated individuals. Weaning from prednisone was achieved in five etanercept-treated participants and in no placebo-treated participants. The time to treatment failure was 358 days in the etanercept group and 148 days in the placebo group. After 24 weeks, the average prednisone dosage was significantly lower in the etanercept group than the placebo group (1.2 mg/day versus 29.2 mg/day). IMACS and other outcome measures showed excellent test-retest reliability (intraclass correlation coefficients, 0.79 to 0.99). Treatment had no significant effect on functional outcome.

"The findings of no major safety concerns and a steroid-sparing effect in our study suggest that further investigation of etanercept as a treatment for dermatomyositis is warranted," the authors write.

Several authors disclosed financial relationships with the pharmaceutical and biotechnology industries, including Amgen, which provided start-up funding, etanercept, and matching placebo.

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