The effect of etanercept on Graves' ophthalmopathy: a pilot study

D Paridaens, W A van den Bosch, T L van der Loos, E P Krenning, P M van Hagen

Research output: Contribution to journalArticleResearchpeer-review


PURPOSE: To assess the effect of etanercept, an antitumour necrosis factor (anti-TNF) drug, on clinical signs in Graves' ophthalmopathy (GO).

METHODS: A total of 10 consecutive patients (seven female, three male) with recent-onset, active, mildly-to-moderately severe GO were treated with subcutaneous injections of 25 mg etanercept (Enbrel) twice weekly during 12 weeks. The average age was 50 years (range: 39-59 years). The average duration of GO was 4 months (range: 2-6 months). All patients were at least 2 months euthyroid with medication. The mean pretreatment clinical activity score (CAS) was 4 (range: 3-6).

RESULTS: The mean CAS prior to treatment was 4, at 6 weeks 2.6, and at 12 weeks 1.6. The mean ophthalmopathy index (OI) prior to treatment was 5.8, at 6 weeks 4.8, and at 12 weeks 4.4. Thus, after 12 weeks of treatment the mean CAS had decreased by 2.4+/-1.3 (60%), and the mean OI had decreased by 1.4+/-1.2 (24%). The main decrease of the CAS and OI was noted at 6 weeks of treatment. The difference was particularly evident on soft-tissue changes, including periocular chemosis and redness. The mean exophthalmometry values did not change. In all, 60% percent of patients reported moderate to marked improvement. In three patients, the GO flared up again after cessation of treatment. There were no serious adverse events or side effects during a mean follow-up time of 18 months.

CONCLUSIONS: This study strongly suggests that etanercept may suppress the clinical signs in GO, but randomized controlled trials are needed to further evaluate the effect of anti-TNF treatment and to compare its side-effects with those of corticosteroids.

Original languageEnglish
Pages (from-to)1286-9
Number of pages4
JournalEye (London, England)
Issue number12
Publication statusPublished - Dec 2005


  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal/adverse effects
  • Etanercept
  • Female
  • Graves Ophthalmopathy/drug therapy
  • Humans
  • Immunoglobulin G/adverse effects
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Pilot Projects
  • Receptors, Tumor Necrosis Factor/therapeutic use
  • Severity of Illness Index
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha/antagonists & inhibitors


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