Experience of antitumor necrosis factor-α therapies in Taiwan

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BackgroundEtanercept (Enbrel), was the first approved biologics in Taiwan for rheumatoid arthritis (RA), juvenile RA (JRA), psoriatic arthritis and ankylosing spondylitis. Approximately 500 patients with RA were under etanercept therapy by April 2006.AimWe aimed to review the current status of biological agents use in the treatment of rheumatic diseases in Taiwan.MethodsMEDLINE database (January 1966 to February 2006) was searched by MeSH terms, limited to Taiwan by author affiliations. All known principal clinical investigators and pharmaceutical companies in Taiwan were contacted for unpublished information about this issue.ResultsSix articles including two clinical trials, two case series and two preclinical studies were found in MEDLINE since January 1966. A 12-week double-blind placebo-controlled study of 58 patients with active adult RA in Taiwan revealed better efficacy than results in Western countries. For JRA, two studies reported good results in polyarticular type JRA but fair response in systemic type. Adalimumab (Humira, Abbott) and Alefacept (Ameviev, Biogen) had completed their local trials in RA and psoriasis but they are not yet available in Taiwan. Widespread usage of biologics has been limited due to restricted insurance coverage policy only to the refractory patients with RA. Some herbs demonstrating TNF-α inhibition properties are under exploratory clinical trials.ConclusionsEtanercept showed better efficacy in patients with adult RA in Taiwan than Western countries. Some herbs demonstrated TNF-α inhibition and are under laboratory and clinical investigations.

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