TY - JOUR T1 - Etanercept Versus Monoclonal Antibodies in Axial Spondyloarthritis: Game Over? JF - The Journal of Rheumatology JO - J Rheumatol SP - 1899 LP - 1902 DO - 10.3899/jrheum.140866 VL - 41 IS - 10 AU - GAËLLE VARKAS AU - DIRK ELEWAUT Y1 - 2014/10/01 UR - http://www.jrheum.org/content/41/10/1899.abstract N2 - More than 10 years of experience with anti-tumor necrosis factor-α (TNF-α) therapy in ankylosing spondylitis (AS) has brought us new therapeutic players. As respectively infliximab (IFX), etanercept (ETN), adalimumab, golimumab, and certolizumab were introduced, we were confronted with new modes of administration. However, regarding efficacy on axial and peripheral manifestations, all 5 actors seem somewhat equipotent. Also, IFX, ETN, adalimumab, and golimumab have already shown longterm efficacy after 2 to 8 years in established AS1,2,3,4. Nevertheless, treatment with TNF-α blocking agents such as adalimumab and ETN has shown similar high efficacy, with up to 54.5% ASAS40 (Assessment of Spondyloarthritis international Society 40%) response in early disease5,6. In this issue of The Journal, Song, et al report results on the longterm efficacy of ETN in patients with early axial spondyloarthritis (axSpA)7. Generally speaking, 2 types of TNF-α therapy are distinguished: ETN, a soluble TNF-α receptor antagonist, and monoclonal antibodies. All TNF blocking agents display similar short-term efficacy in axSpA4,8,9,10,11,12 (Figure 1). Adalimumab displayed sustained clinical efficacy after 2 years of treatment with an ASAS40 response of 39.4% at Week 24 to an ASAS40 response in 50.6% after 2 years2,10. Also IFX maintained ASAS20 response of 84.8% after 8 years of treatment13. Similar results can be found in ETN and golimumab after 2 years3,4. However, all of these followup studies have been published in AS, generally comprising patients with longer disease duration and more … Address correspondence to Dr. Elewaut, University of Ghent, Rheumatology, De Pintelaan 185, Ghent 9000 Belgium; E-mail: dirk.elewaut{at}ugent.be ER -