Clinical and radiographic results from a 2-year comparison of once-weekly versus twice-weekly administration of etanercept in biologics-naive patients with rheumatoid arthritis

Objectives The twice-weekly administration of 25 mg of etanercept (TW) has been shown to be effective in patients with rheumatoid arthritis (RA). However, the once-weekly administration of 25 mg of etanercept (OW) was tried in order to address the economic burden of anti-rheumatic biologics. We evaluated the clinical and radiographic results from a 2-year follow-up study of patients receiving OW or TW. Methods Sixty-three biologics-naive patients with RA were randomly assigned to receive either OW (n = 42) or TW (n = 21). Results From baseline to year 2, rates of clinical remission, according to the Disease Activity Score of 28 joints (DAS-28) (based on C-reactive protein; CRP)-with clinical remission being regarded as a DAS-28 (CRP) score of <2.3-were significantly improved in the OW group (from 1.6 to 39.0%) and in the TW group (from 9.5 to 47.6%), but no significant between-group difference was observed at year 2. Radiographic joint damage, quantified with the modified Sharp score, was significantly progressive in the OW group in contrast to findings in the TW group. Thus, among patients receiving TW therapy, the progression of joint damage may have been inhibited or may have shown remission. Conclusions These results suggest that, in terms of DAS-28 remission, OW therapy can efficiently substitute for TW therapy in biologics-naive patients with RA. However, TW therapy was indispensable in preventing the worsening of joint damage.