Etanercept reduces synovitis as measured by magnetic resonance imaging in patients with active rheumatoid arthritis after only 6 weeks

OBJECTIVE: To demonstrate the efficacy of etanercept to reduce synovitis as measured by magnetic resonance imaging (MRI) as early as 6 weeks after starting treatment in patients with active rheumatoid arthritis (RA). METHODS: Twenty-two patients with active RA despite disease modifying antirheumatic drug (DMARD) treatment were included in this prospective, controlled study. Patients were randomized in 2 groups. In the treatment group, etanercept was added at usual doses during 6 weeks. In the control group, patients continued with prior DMARD therapy. MRI of the dominant wrist and 2nd-5th MCP joints were obtained at baseline and at 6 weeks and evaluated according to OMERACT recommendations. Results of changes in synovitis in the treatment group were compared with changes in the control group. RESULTS: Changes in synovitis measured by MRI of the hand (OMERACT evaluation) in the etanercept group showed a significant reduction after 6 weeks of treatment compared with no changes in the control group. Reduction of synovitis in the treatment group also showed good correlation with decrease of various clinical and laboratory measures. CONCLUSION: In patients with active RA despite DMARD therapy, etanercept, but not placebo, reduced synovitis as measured by MRI after 6 weeks.