Efficacy of etanercept in the tumor necrosis factor receptor-associated periodic syndrome (TRAPS)

Arthritis & Rheumatism, 11/09/2011

Bulua AC et al. – Etanercept reduces symptoms and serum inflammatory markers of TRAPS in a dose–dependent manner, but does not completely normalize symptoms or acute phase reactants. Although long–term adherence to etanercept is poor, remaining on etanercept may provide continued symptomatic benefit.


  • Fifteen patients with TRAPS were enrolled in a prospective, open–label, dose–escalation study.
  • Patients recorded attacks, symptom severity, and use of ancillary medications in a daily diary.
  • Blood samples were collected during each period and measured for acute phase reactants.
  • 7–9 years after the conclusion of the initial study, patients completed a follow–up survey and were evaluated to determine the long–term outcome of etanercept treatment.


  • Etanercept treatment significantly attenuated the total symptom score, as well as reduced the frequency of symptoms.
  • Etanercept also reduced acute phase reactants, particularly during asymptomatic periods.
  • During a ten–year follow–up period, patients remained on etanercept for a median of 3.3 years, with a number of patients switching to anti–IL–1β therapy or remaining off biologic agents, citing injection reactions and lack of efficacy most frequently for discontinuation.
  • Patients remaining on etanercept had reduced symptoms at follow–up.

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