Etanercept dosage for psoriasis and psoriatic arthritis

About 30% of people with psoriasis develop psoriatic arthritis. Etanercept is used for the treatment of moderate to severe psoriasis, and for active psoriatic arthritis. Now, doses of 50 mg weekly or twice weekly have been compared in an international study.

A total of 752 patients with both psoriasis and psoriatic arthritis were randomized at 98 centres in Europe, Latin America and the Asia Pacific to subcutaneous etanercept 50 mg once or twice weekly for 12 weeks, after which all participants received the weekly dosage for another 12 weeks.

At week 12, the psoriasis was clear or almost clear in 32% (once weekly) vs 46% (twice weekly), a significant difference. A significant response of the psoriatic arthritis was achieved by the end of the trial in 76% vs 77%. No new adverse effects of etanercept were noted.

These researchers suggest that the twice weekly dosage may be better for the skin disease, but once weekly may be enough for joint disease.

Sterry W et al. Comparison of two etanercept regimens for treatment of psoriasis and psoriatic arthritis: PRESTA randomized double blind multicentre trial. BMJ 2010;340:300 (c147), Gladman DD. Etanercept for psoriatic arthritis. Ibid:272–273 (editorial).