Etanercept: An Evolving Role in Psoriasis and Psoriatic Arthritis

  • Srdjan Prodanovich
  • Carlos Ricotti
  • Brad P. Glick
  • Luca Inverardi
  • Craig L. Leonardi
  • Francisco Kerdel
Review Article


Tumor necrosis factor alpha (TNFα) plays a key pathophysiological role in psoriasis and psoriatic arthritis (PsA). Recent interest has thus focused on the clinical potential of TNFα antagonists (e.g. etanercept) in these settings. In psoriasis, several large pooled analyses and well-designed clinical trials documented the significant clinical efficacy and generally favorable tolerability of etanercept for up to 96 weeks. Similarly, in PsA, a large phase III trial showed that, etanercept significantly reduced arthritic symptoms and inhibited radiographic disease progression; sustained clinical benefit was again evident for up to 2 years. Etanercept is at the forefront of psoriatic disease management, and continued evolution and evaluation of the compound–for example, in detailed comparative studies and economic analyses—is likely to confirm a key role for etanercept in the treatment of psoriasis and PsA.


  1. 1.
    Fuch BS, Hadi S. Use of etanercept in the treatment of psoriasis and psoriatic arthritis. Rev Recent Clin Trials 2006; 1: 259–63CrossRefGoogle Scholar
  2. 2.
    Romero-Mate A, Garcia-Donoso C, Cordoba-Guijarro S. Efficacy and safety of etanercept in psoriasis/psoriatic arthritis: an updated review. Am J Clin Dermatol 2007; 8: 143–55PubMedCrossRefGoogle Scholar
  3. 3.
    National Psoriasis Foundation. About psoriatic arthritis. [cited 2008 30 December]; Available from:
  4. 4.
    Mease P, Goffe BS. Diagnosis and treatment of psoriatic arthritis. J Am Acad Dermatol 2005; 52: 1–19PubMedCrossRefGoogle Scholar
  5. 5.
    Ackermann C, Kavanaugh A. Economic burden of psoriatic arthritis. Pharmacoeconomics 2008; 26: 121–9PubMedCrossRefGoogle Scholar
  6. 6.
    Gottlieb AB, Chao C, Dann F. Psoriasis comorbidities. J Dermatolog Treat 2008; 19: 5–21PubMedCrossRefGoogle Scholar
  7. 7.
    Gladman DD. Mortality in psoriatic arthritis. Clin Exp Rheumatol 2008; 26 (5 Suppl. 51): S62–5Google Scholar
  8. 8.
    Gulliver W. Long-term prognosis in patients with psoriasis. Br J Dermatol 2008; 159 (Suppl. 2): 2–9PubMedCrossRefGoogle Scholar
  9. 9.
    Mallbris L, Ritchlin CT, Stahle M. Metabolic disorders in patients with psoriasis and psoriatic arthritis. Curr Rheumatol Rep 2006; 8: 355–63PubMedCrossRefGoogle Scholar
  10. 10.
    Wong K, Gladman DD, Husted J, et al. Mortality studies in psoriatic arthritis: results from a single outpatient clinic. I. Causes and risk of death. Arthritis Rheum 1997; 40: 1868–72Google Scholar
  11. 11.
    Lebwohl MG. Use of etanercept in the dermatology setting. A review. Am J Clin Dermatol 2005; 6: 49–59Google Scholar
  12. 12.
    Warren RB, Brown BC, Griffiths CE. Topical treatments for scalp psoriasis. Drugs 2008; 68: 2293–302PubMedCrossRefGoogle Scholar
  13. 13.
    Lebwohl M. Psoriasis. Lancet 2003; 361: 1197–204PubMedCrossRefGoogle Scholar
  14. 14.
    Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol 2008; 58: 826–50Google Scholar
  15. 15.
    Gottlieb A, Korman NJ, Gordon KB, et al.Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol 2008; 58: 851–64Google Scholar
  16. 16.
    European Medicines Authority. Etanercept (Enbrel®): summary of product characteristics. [cited 2008 30 December]; Available from:
  17. 17.
    Food and Drug Administration. Etanercept (Enbrel®): product information. 2008 [cited 2008 30 December]; Available from:
  18. 18.
    Gelfand JM, Gladman DD, Mease PJ, et al. Epidemiology of psoriatic arthritis in the population of the United States. J Am Acad Dermatol 2005; 53: 573.e1–573.e13CrossRefGoogle Scholar
  19. 19.
    Sanchez Carazo JL, Mahiques Santos L, Oliver Martinez V. Safety of etanercept in psoriasis: a critical review. Drug Saf 2006; 29: 675–85CrossRefGoogle Scholar
  20. 20.
    Shear NH. Fulfilling an unmet need in psoriasis: do biologicals hold the key to improved tolerability? Drug Saf 2006; 29: 49–66PubMedCrossRefGoogle Scholar
  21. 21.
    Brimhall AK, King LN, Licciardone JC, et al. Safety and efficacy of alefacept, efalizumab, etanercept and infliximab in treating moderate to severe plaque psoriasis: a meta-analysis of randomized controlled trials. Br J Dermatol 2008; 159: 274–85PubMedCrossRefGoogle Scholar
  22. 22.
    Gordon K, Korman N, Frankel E, et al. Efficacy of etanercept in an integrated multistudy database of patients with psoriasis. J Am Acad Dermatol 2006; 54 (3 Suppl. 2): S101–11CrossRefGoogle Scholar
  23. 23.
    Gottlieb AB, Leonardi CL, Goffe BS, et al. Etanercept monotherapy in patients with psoriasis: a summary of safety, based on an integrated multistudy database. J Am Acad Dermatol 2006; 54 (3 Suppl. 2): S92–100CrossRefGoogle Scholar
  24. 24.
    Gottlieb AB, Matheson RT, Lowe N, et al. A randomized trial of etanercept as monotherapy for psoriasis. Arch Dermatol 2003; 139: 1627–32; discussion on page 1632PubMedCrossRefGoogle Scholar
  25. 25.
    Leonardi CL, Powers JL, Matheson RT, et al. Etanercept as monotherapy in patients with psoriasis. N Engl J Med 2003; 349: 2014–22PubMedCrossRefGoogle Scholar
  26. 26.
    Paller AS, Siegfried EC, Langley RG, et al. Etanercept treatment for children and adolescents with plaque psoriasis. N Engl J Med 2008; 358: 241–51PubMedCrossRefGoogle Scholar
  27. 27.
    Papp KA, Tyring S, Lahfa M, et al. A global phase III randomized controlled trial of etanercept in psoriasis: safety, efficacy, and effect of dose reduction. Br J Dermatol 2005; 152: 1304–12PubMedCrossRefGoogle Scholar
  28. 28.
    Tyring S, Gordon KB, Poulin Y, et al. Long-term safety and efficacy of 50 mg of etanercept twice weekly in patients with psoriasis. Arch Dermatol 2007; 143: 719–26PubMedCrossRefGoogle Scholar
  29. 29.
    Moore A, Gordon KB, Kang S, et al. A randomized, open-label trial of continuous versus interrupted etanercept therapy in the treatment of psoriasis. J Am Acad Dermatol 2007; 56: 598–603PubMedCrossRefGoogle Scholar
  30. 30.
    Tyring S, Gottlieb A, Papp K, et al. Etanercept and clinical outcomes, fatigue, and depression in psoriasis: double-blind placebo-controlled randomised phase III trial. Lancet 2006; 367: 29–35PubMedCrossRefGoogle Scholar
  31. 31.
    Mease PJ, Kivitz AJ, Burch FX, et al. Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression. Arthritis Rheum 2004; 50: 2264–72PubMedCrossRefGoogle Scholar
  32. 32.
    Mease PJ, Kivitz AJ, Burch FX, et al. Continued inhibition of radiographic progression in patients with psoriatic arthritis following 2 years of treatment with etanercept. J Rheumatol 2006; 33: 712–21PubMedGoogle Scholar
  33. 33.
    Gottlieb AB, Kircik L, Eisen D, et al. Use of etanercept for psoriatic arthritis in the dermatology clinic: the Experience Diagnosing, Understanding Care, and Treatment with Etanercept (EDUCATE) study. J Dermatolog Treat 2006; 17: 343–52PubMedCrossRefGoogle Scholar
  34. 34.
    Kimball AB, Jackson JM, Sobell JM, et al. Reductions in healthcare resource utilization in psoriatic arthritis patients receiving etanercept therapy: results from the EDUCATE trial. J Drugs Dermatol 2007; 6: 299–306PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • Srdjan Prodanovich
    • 1
  • Carlos Ricotti
    • 1
  • Brad P. Glick
    • 1
  • Luca Inverardi
    • 1
  • Craig L. Leonardi
    • 1
  • Francisco Kerdel
    • 1
  1. 1.Florida Academic Dermatology CentersMiamiUSA

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