Bernstein LE et al. (2006) Effects of etanercept in patients with the metabolic syndrome. Arch Intern Med 166: 902–908

Etanercept is currently approved by the FDA to treat patients with inflammatory arthritis. Here, Bernstein et al. assessed the effects of etanercept on markers of inflammation associated with tumor necrosis factor (TNF) production, in patients with the metabolic syndrome. In these patients, adipocytes secrete cytokines such as TNF that trigger an inflammatory response, which results in increased levels of C-reactive protein and decreased levels of adiponectin. This inflammatory response is thought to increase the risk of cardiovascular disease in patients with the metabolic syndrome.

Their study enrolled 56 patients with the metabolic syndrome, who were recruited from the Massachusetts General Hospital and the Massachusetts Institute of Technology, Boston, MA, USA. The patients were randomly allocated to receive either 50 mg etanercept or placebo subcutaneously. After 4 weeks of treatment, levels of C-reactive protein decreased by 34% and adiponectin levels increased in patients who received etanercept, compared with patients who received placebo. Furthermore, fibrinogen levels and interleukin 6 levels decreased in patients taking the study drug compared with placebo. Etanercept was well tolerated by patients throughout the study.

The authors conclude that etanercept blocks the inflammatory response by acting as a TNF antagonist and, therefore, might be an effective, novel treatment for patients with the metabolic syndrome. Longer-term studies with larger sample sizes that the present study are, however, needed to confirm these results.