Enbrel and Asthma

[Guest guest]

Georgina:

How interesting that you found this article!

Rob has had asthma since 11 months old. His pulmonary function,

particularly his diffusion capacity, was affected. At age 12, after

diagnosis with juvenile ankylosing spondylitis, his diffusion capacity

was around 50% of normal. This month he was re-tested, and it has risen

(steadily, he's been rechecked every year) to 79%! Which is 'just a hair'

below normal! We attribute this entirely to Enbrel!

His pulmonologist believes that the JAS affected the alveolar-capillary

membrane, making it thickened, stiff and inflamed. The Enbrel is the only

differing factor every year that we've checked since the initial abnormal

results, and it is felt to be the cause of his significant improvement in

lung function!

We are feeling really blessed in this direction!

I'm going to forward this article on to his pediatrician who is always

interested in Rob's unusual case.

Thank you!

and Rob 16 Spondy

On Thu, 16 Feb 2006 22:57:08 -1000 " Georgina " <gmckin11@...>

writes:

Rheumatoid Arthritis Drug Could Fight Problem Asthma

http://www.forbes.com/lifestyle/health/feeds/hscout/2006/02/16/hscout5310

57.html

THURSDAY, Feb. 16 (HealthDay News) -- Using a well-known rheumatoid

arthritis drug to reduce high levels of an inflammatory protein could be

a

new means of fighting severe asthma, British researchers report.

Their study found that people with severe asthma have higher-than-normal

concentrations of an inflammation-linked cytokine called tumor necrosis

factor alpha (TNFa). Reducing the levels using a TNF-inhibiting drug,

etanercept, reduced asthma symptoms in people with refractory -- hard to

manage -- disease.

" Open-label use of etanercept for three months in patients with

refractory

asthma improved airflow measures and symptoms scores, and reduced

bronchial

hyperresponsiveness, " wrote Dr. Serpil Erzurum, from the Cleveland

Clinic,

in an editorial accompanying the study in the Feb. 16 issue of the New

England Journal of Medicine.

However, Erzurum also cautioned against widespread use of TNF inhibitors

in

the treatment of asthma until more studies are done, because these

medications can have serious side effects. Potential side effects include

a

boost in risk for serious infections such as pneumonia, as well as an

increased cancer risk.

Asthma, which affects about 20 million Americans, is a chronic disease of

the airways that can cause wheezing, difficulty breathing and shortness

of

breath, according to the National Heart, Lung, and Blood Institute.

Numerous

medications are available to treat the disorder, and with proper

treatment

most people can keep it under control.

However, according to Erzurum, in about 10 percent of the cases, asthma

becomes very hard to control, severely impacting on quality of life. Many

patients must make chronic use of oral steroids, which can have

significant

side effects. These hard-to-manage cases account for about half of the

health-care costs linked to asthma. They also represent a large portion

of

asthma complications and deaths.

Etanercept, sold under the brand name Enbrel, is a TNF-inhibitor drug

already prescribed for autoimmune diseases such as rheumatoid arthritis

or

ankylosing spondylitis.

The first phase of the current study compared 10 people who didn't have

asthma to 10 people with mild-to-moderate asthma and another 10 people

with

tough-to-treat disease. British researchers from the National Health

Service

looked for differences in the levels of TNFa between these three groups.

They found that people with severe asthma had about twice the TNFa

activity

as people without asthma. Severe asthmatics also had higher levels than

people with mild-to-moderate asthma.

Dr. Field, director of the allergy and asthma clinic at New York

University Medical Center/Bellevue in New York City, said he wasn't

surprised by the findings.

" TNF is one of the many inflammatory cytokines linked to allergy and

autoimmune diseases. This is one of the times it has been

well-documented,

however, " he said.

To further examine the role of TNF in refractory asthma, the researchers

tested the known TNF inhibitor, etanercept, on participants with

hard-to-control disease. Half began the study taking etanercept twice a

week

for 10 weeks, while the other half received a placebo. After a one-month

rest, the groups were switched and those that had received the placebo

were

now given the drug and vice-versa. During the study, neither the

researchers

nor the patients knew who was receiving the medication.

Asthma severity, measured by lung function tests, was significantly

reduced

for those taking the medication, the study found. On a quality-of-life

scale

of seven points, scores improved by an average of nearly one point when

people were taking etanercept compared to the placebo.

The authors point out that their findings are only applicable to those

with

severe asthma, and not for those with mild-to-moderate asthma. That's

because these milder cases don't have the high levels of TNF seen in

people

with severe asthma.

" For people with severe, refractory asthma, this may be a hopeful adjunct

therapy, but we have to be very aware of the potential side effects, "

said

Field.

Field added that more studies need to be done on much larger groups of

people before this could possibly become a standard treatment.

Dr. Malourdes de Asis, chief of allergy at Nyack Hospital in New York,

echoed Field's sentiments.

" This is a promising therapy for people with refractory asthma, but it's

expensive and we still need more studies and a multi-center trial, " she

said.

" Have no fear for what tomorrow may bring. The same loving God who cares

for you today will take care of you tomorrow and every day. God will

either shield you from suffering or give you unfailing strength to bear

it. Be at peace, then, and put aside all anxious thoughts and

imaginations. "

-St Francis DeSales