Summary

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• Enbrel (etanercept) is indicated for the treatment of rheumatoid arthritis (RA), the treatment of polyarticular juvenile idiopathic arthritis (JIA) in patients aged 2 years or older, the treatment of psoriatic arthritis (PsA), the treatment of ankylosing spondylitis (AS), and the treatment of plaque psoriasis (PsO) in patients 4 years or older.
• This summary is based on the review of 40 systematic review(s)/meta-analysis(es). ^[1-40]
• Dementia Risk in RA Patients: Biological DMARDs, including TNF inhibitors, are associated with a reduced risk of developing dementia in RA patients (RR 0.76, 95% CI 0.72 to 0.80). Specific reductions observed for etanercept (RR 0.58, 95% CI 0.53 to 0.65), adalimumab (RR 0.65, 95% CI 0.59 to 0.72), and infliximab (RR 0.80, 95% CI 0.72 to 0.88).
• Primary Autoimmune Inner Ear Disease (AIED): DMARDs, including etanercept, significantly improved auditory outcomes in AIED patients, with mean differences in pure-tone audiometry (-2.1 dB) and speech discrimination scores (13.9%). 38 adverse events were reported across 7 studies, with 4 classified as serious.
• Switching Between Biologics and Biosimilars for RA: The effectiveness of switching to biosimilars in RA patients is comparable to continuing biologics, with ACR20 (RR 0.98, 95% CrIs 0.93 to 1.03) and HAQ-DI (SMD -0.07, 95% CrIs -0.23 to 0.1) showing no significant differences. Safety results were comparable between switching to biosimilars and continuing biologics, though results were imprecise, and long-term safety effects were not well-established.
• Juvenile Idiopathic Arthritis (JIA): Etanercept is effective in juvenile idiopathic arthritis, with response rates for JIA-ACR30 (73-94%), JIA-ACR50 (53-78%), JIA-ACR70 (36-59%), and JIA-ACR90 (28%), comparable to other TNF inhibitors like adalimumab and infliximab. The incidence of serious adverse events (SAEs) for etanercept ranged from 0 to 20.0 SAE/100 patient-years.
• Reduced dementia risk in RA patients using biological DMARDs, effective response and safety in juvenile idiopathic arthritis patients, and prevention of radiographic progression in psoriatic arthritis with anti-TNF agents are notable findings.