Eguchi Katsumi
Graduate School of Biomedical Sciences, Nagasaki University.
Nihon Rinsho. 2007 Jul;65(7):1259-66.
Etanercept is a soluble tumor necrosis factor (TNF) receptor fusion protein that binds and inactivates TNF. Since etanercept was just approved in January 2005 in Japan, a strict postmarketing surveillance has been undertaken. In this trial, initial 3,319 patients with rheumatoid arthritis were collected, and the adverse events and efficacy of etanercept were evaluated. The frequency of adverse events were found in 30.9 %, among total patients particularly severe adverse effects in 4.2 %. Among severe adverse events, 83 patients experienced infection. They included 25 patients with bacterial pneumonia. Interstitial pneumonia, pneumocystis jiroveci and tuberculosis were observed in 11 cases (0.3 %), 5 cases (0.2 %) and 2 cases (0.1%), respectively. Patients who received etanercept had a more rapid rate of improvement in disease activity determined by DAS 28 ESR and DAS28 CRP. These improvements continued through 24 months of etanercept exposure. Using the analysis of EULAR response criteria, the good or moderate response in the DAS 28 ESR response and DAS 28 CRP was found in more than 80% of patients with RA.
依那西普是一种可溶性肿瘤坏死因子(TNF)受体融合蛋白,可结合并使TNF失活。由于依那西普于2005年1月刚刚在日本获批,因此开展了严格的上市后监测。在该试验中,收集了最初的3319例类风湿性关节炎患者,并对依那西普的不良事件和疗效进行了评估。在所有患者中,不良事件的发生率为30.9%,其中特别严重的不良反应发生率为4.2%。在严重不良事件中,有83例患者发生感染。其中包括25例细菌性肺炎患者。间质性肺炎、耶氏肺孢子菌肺炎和肺结核分别有11例(0.3%)、5例(0.2%)和2例(0.1%)。接受依那西普治疗的患者,通过DAS 28 ESR和DAS28 CRP测定的疾病活动改善速度更快。这些改善在依那西普治疗的24个月内持续存在。根据欧洲抗风湿病联盟(EULAR)反应标准分析,超过80%的类风湿性关节炎患者在DAS 28 ESR反应和DAS 28 CRP方面有良好或中等反应。