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Etanercept (Enbrel), an inhibitor of tumor necrosis factor, is approved for use as monotherapy in patients with rheumatoid arthritis (RA). In a previously published, industry-sponsored study (N Engl J Med 2000; 343:1586), 632 adults with early, active RA were randomized to receive either etanercept (10 or 25 mg subcutaneously, twice weekly) or weekly oral methotrexate. At 1 year, clinical improvement in the 2 groups was similar, but there was significantly less radiographic progression in the etanercept group. Now, 2-year outcomes are reported.
At 2 years, the proportion of patients with at least 20% improvement on a standardized clinical score was significantly greater with 25-mg etanercept than with methotrexate (72% vs. 59%). In addition,…