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Azilsartan improves the effects of etanercept in patients with active rheumatoid arthritis: a pilot study

Naza Mohammed Ali Mahmood1, Saad Abdulrahman Hussain2, Raouf Rahim Mirza3

  • 1Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq.

Therapeutics and Clinical Risk Management
|August 21, 2018
PubMed
Abstract

Insights

Adding azilsartan to etanercept significantly improved pain and disease activity markers in rheumatoid arthritis patients. Blocking the renin-angiotensin system (RAS) with azilsartan enhanced etanercept

Area of Science:

  • Immunology
  • Rheumatology
  • Pharmacology

Background:

  • The renin-angiotensin system (RAS) is implicated in inflammatory processes.
  • Rheumatoid arthritis (RA) involves chronic inflammation and immune system dysregulation.

Purpose of the Study:

  • To investigate the impact of azilsartan (Azil), a RAS blocker, on the clinical effectiveness of etanercept (Etan) in active RA patients.
  • To assess if combining Azil with Etan improves treatment outcomes compared to Etan alone.

Main Methods:

  • A pilot study involved 42 RA patients with inadequate response to methotrexate.
  • Patients received either Etan (50 mg/week) plus placebo or Etan plus Azil (20 mg/day) for 90 days.
  • Disease activity was measured using DAS-28, SDAI, CDAI, and HAQ-DI; inflammatory markers (CRP, ESR) were also assessed.

Main Results:

  • Combination therapy with Etan and Azil resulted in significant improvements in pain and disease activity markers.
  • Key indicators such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) showed marked reduction with Azil co-administration.
  • Patients receiving Etan plus Azil demonstrated superior clinical outcomes compared to those on Etan plus placebo.

Conclusions:

  • Azilsartan, by blocking the RAS, may enhance the therapeutic effects of etanercept in managing active RA.
  • This combination therapy shows promise for patients with RA refractory to methotrexate.
  • Targeting the RAS alongside anti-TNF therapy could be a viable strategy for improving RA treatment.
Keywords:
DAS-28HAQ-DISDAIazilsartanetanerceptrheumatoid arthritis

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