This is an open label, multicenter study for extended treatment of patients who have participated in the Immunex clinical study 016.0012. The primary objective of this study is to evaluate the long term safety of etanercept (TNFR:Fc) in patients with early stage rheumatoid arthritis.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
468
Etanercept (TNFR:Fc) will be administered 50 mg per week as two 25 mg subcutaneous injections at separate sites, given either on the same day or 3 or 4 days apart.
Total Exposure to Etanercept With Gaps
Total participant exposure to etanercept (Enbrel) with gaps, calculated as the sum of the times on treatment for all participants. Gaps of up to 14 days from the last treatment in a previous Etanercept study were ignored in calculating time on treatment.
Time frame: Up to 8 years
Total Exposure-Adjusted Rate of Malignancies
Exposure-adjusted rate of malignancies, excluding nonmelanoma skin cancers, occurring on study within 30 days of the last dose of etanercept
Time frame: Up to 8 years
Total Exposure-Adjusted Rate of Deaths
Rate of deaths within 30 days of the last dose of etanercept, adjusted for total exposure to etanercept
Time frame: Up to 8 years
Total Exposure Adjusted Rate of Serious Infectious Events
Exposure-adjusted rate of serious infectious events (associated with hospitalization or IV antibiotics) occurring on study within 30 days of the last dose of etanercept
Time frame: Up to 8 years
Total Exposure Adjusted Rate of Lymphomas
Rate of lymphomas occurring on study within 30 days of the last dose of etanercept, adjusted for total exposure to etanercept
Time frame: Up to 8 years
Malignancy
Occurrence of one or more malignancies within the participant on study within 30 days of the last dose of etanercept
Time frame: Up to 8 years
Lymphoma
Occurrence of one or more lymphomas on study within 30 days of the last dose of etanercept
Time frame: Up to 8 years
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Serious Infectious Event
Occurrence of one or more serious infectious events within the participant on study within 30 days of the last dose of study medication
Time frame: Up to 8 years
Total Exposure Adjusted Rate of Serious Adverse Events
Rate of serious adverse events adjusted to total exposure to etanercept (events / exposure \* 100)
Time frame: Up to 8 years
Death
Death of the participant on study up to 30 days after the last dose of etanercept
Time frame: Up to 8 years
ACR20 Response at Month 3
American College of Rheumatology (ACR) 20, defined as a 20% improvement in both tender and swollen joints (78 joints) and a 20% improvement in 3 of 5 items (physician and patient global assessments, patient pain assessment, patient self-assessed disability, and acute-phase C-reactive protein or erythrocyte sedimentation rate)
Time frame: Baseline and month 3
Dosing Period
Duration of etanercept dosing
Time frame: Up to 8 years
ACR20 Response at Month 12
American College of Rheumatology (ACR) 20, defined as a 20% improvement in both tender and swollen joints (78 joints) and a 20% improvement in 3 of 5 items (including physician and patient global assessments), in adults
Time frame: Baseline and month 12
ACR50 Response at Month 12
American College of Rheumatology (ACR) 50, defined as a 50% improvement in both tender and swollen joints (78 joints) and a 50% improvement in 3 of 5 items (including physician and patient global assessments), in adults
Time frame: Baseline and month 12
ACR70 Response at Month 12
American College of Rheumatology (ACR) 70, defined as a 70% improvement in both tender and swollen joints (78 joints) and a 70% improvement in 3 of 5 items (including physician and patient global assessments), in adults
Time frame: Baseline and month 12
Standardized Incidence Rate for All SEER Cancers
Standardized incidence rate for all cancers tracked by the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) system, calculated as the ratio of the observed to expected age- and sex-adjusted incidence rates (per person-year) of cancer. Expected rates were based on 1998-2002 SEER data.
Time frame: Up to 8 years
Percent Improvement in Physician Global Assessment of Disease Status From Baseline to Month 12
Percent improvement in the Physician Global Assessment of disease status from baseline to month 12, assessed using a 0 - 10 Likert scale, where 0 = asymptomatic and 10 = severe symptoms
Time frame: Baseline and month 12
Percent Improvement in Participant Global Assessment of Disease Status From Baseline to Month 12
Percent improvement in the Participant Global Assessment of disease status from baseline to month 12, assessed using a 0 - 10 Likert scale, where 0 = asymptomatic and 10 = severe symptoms
Time frame: Baseline and Month 12
Percent Improvement in Participant Pain Visual Analog Scale From Baseline to Month 12
Percent improvement in the Participant Pain Visual Analog Scale (VAS) from baseline to month 12, using a 10 cm scale ranging from "no pain" (0 cm) to "severe pain" (10 cm).
Time frame: Baseline and month 12
Percent Improvement in Tender Joint Count From Baseline to Month 12
Percent improvement in tender joint count (based on up to 71 joints) from baseline to month 12. Tender joints were assessed clinically, and the number of such joints was counted at each time point.
Time frame: Baseline and month 12
Percent Improvement in Swollen Joint Count From Baseline to Month 12
Percent improvement in swollen joint count (based on up to 68 joints) from baseline to month 12.
Time frame: Baseline and month 12
Percent Improvement in HAQ DI From Baseline to Month 12
Percent improvement in the Health Assessment Questionnaire Disability Index (HAQ DI) from baseline to month 12.
Time frame: Baseline and month 12
Percent Improvement in the Physical Component Summary Score for SF-36 From Baseline to Month 12
Percent improvement in the Physical Component Summary Score for the Short Form 36 Health Survey (SF-36) from baseline to month 12. This score has a range of 0 to 100, with higher scores indicating better health.
Time frame: Baseline and month 12
Percent Improvement in Mental Component Summary Score of SF-36 From Baseline to Month 12
Percent improvement in the Mental Component Summary Score of the Short Form 36 Health Survey (SF-36) from baseline to month 12. This score has a range of 0 to 100, with higher scores indicating better health.
Time frame: Baseline and month 12
Percent Improvement in C-Reactive Protein From Baseline to Month 12
Percent improvement in C-reactive protein from baseline to month 12
Time frame: Baseline and month 12
Percent Improvement in Duration of Morning Stiffness From Baseline to Month 12
Percent improvement in the duration of morning stiffness from baseline to month 12
Time frame: Baseline and month 12
Change From Baseline to Year 2 in Total Sharp Score
Change from baseline to year 2 in Total Sharp Score. This score has a range of 0 to 398, where 0 = no change and higher scores represent a worsening of joint erosions and joint space narrowing.
Time frame: Baseline, Year 2
Change From Baseline to Year 2 in Sharp Score Erosion Subscale
Change from baseline to year 2 in the joint erosion subscale of the Total Sharp Score. This subscale has a range of 0 to 230, where 0 = no change and higher values represent a worsening in joint erosions.
Time frame: Baseline, Year 2
Change From Baseline to Year 2 in Sharp Score Joint Space Narrowing Subscale
Change from baseline to year 2 in the joint space narrowing subscale of the Total Sharp Score. This subscale has a range of 0 to 168, where 0 = no change and higher values represent a worsening of joint space narrowing.
Time frame: Baseline, Year 2