Long-Term Psoriasis Relief With Enbrel
Reassuring 2-Year Enbrel Data Show Safety, Lasting Psoriasis Effect
June 18, 2007 -The psoriasis-easing effect of Enbrel, a drug that dampens
inflammatory immune responses, lasts for at least two years, a large-scale
clinical trial shows.
Enbrel acts like a very specific sponge that soaks up only one thing: a
chemical messenger called tumor necrosis factor or TNF. TNF plays a major role
in psoriasis by triggering inflammatory, skin-damaging, arthritis-causing
Because TNF also helps the body fight off infection and cancer, there have
been nagging worries that safety problems might arise in patients on long-term
Enbrel treatment -- especially those who need higher doses. Also, doctors
wondered whether the drug's psoriasis-easing effects would wear off over
To answer these questions, Stephen Tyring, MD, PhD, of the University of
Texas Health Science Center at Houston and colleagues signed up 618 adult
psoriasis patients for the study.
To enter the study, patients had to have at least "moderate"
psoriasis -- that is, psoriasis affecting 10% of their body surface. Study
patients tended to have much more severe disease, with an average 27% of their
body surface affected. also, at least one systemic psoriasis treatment or
phototherapy had to have failed to help.
Patients received twice-weekly injections (under the skin) of Enbrel at the
50-milligram dose for 96 weeks -- nearly two years. Half the patients received
placebo injections for the first 12 weeks of the study. After that, everyone in
the study got Enbrel.
The results: At week 96, half the patients in both groups had at least a 75%
reduction in psoriasis severity without any increase in infections or other
Enbrel: Safe & Effective So Far
"Safety is always of utmost concern," Tyring tells WebMD. "We
saw no increased risk of heart attacks or anything else. And safety did not
appear to be a problem in terms of cancers or malignancies."
A main question for long-term Enbrel treatment is whether its effects wear
off for patients who take high doses for a long time.
"The answer is, psoriasis clearance was maintained," Tyring says.
"The bottom line is that all of this is an understatement. In real life we
rarely tell patients, 'Just use this Enbrel and that is it.' We use these
psoriasis medications in combination -- a topical solution on the legs or
scalp, and also light therapy. When we do that, we see efficacy far beyond that
noted in the study."
University of Miami researcher Jonette Keri, MD, PhD, chief of dermatology
at the Miami VA Hospital, says she has patients whose psoriasis flares up
unless she keeps them on the high doses of Enbrel used in the Tyring study.
"This study should give some reassurance to patients that they are not
at any higher risk of cancer if they take Enbrel long term," Keri tells
WebMD. Keri was not involved in the Tyring study but will be one of the
investigators in another long-term study of Enbrel.