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This article is part of the supplement: Proceedings of the 8th Global Arthritis Research Network (GARN) Meeting and 1st Bio-Rheumatology International Congress (BRIC)

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Methotrexate alone and methotrexate combined with etanercept in treatment of rheumatoid arthritis

Sylejman Rexhepi1*, Mjellma Rexhepi1, Blerta Rexhepi2, Vjollca Sahatçiu-Meka3 and Vigan Mahmutaj2

  • * Corresponding author: Sylejman Rexhepi

Author Affiliations

1 Rheumatology Department, University of Prishtina, Prishtina, Kosova, 10000

2 Private Clinic "Rheuma", Prishtina, Kosova, 10000

3 Physical Medicine Department, University of Prishtina, Kosova, 10000

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Arthritis Research & Therapy 2012, 14(Suppl 1):P60  doi:10.1186/ar3661

The electronic version of this article is the complete one and can be found online at:

Published:9 February 2012

© 2012 Rexhepi et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The aim of this study is to evaluate the efficacy and safety of methotrexate (MTX) alone and combined therapy of Etanercept (ETN) and methotrexate (MTX), in patients with rheumatoid arthritis (RA).


Patients with RA were treated in combination with ETN (with doses of 25 mg subcutaneously twice weekly), with oral MTX (doses up to 20 mg weekly), and alone MTX (doses up to 20 mg weekly) in period of two years, in Rheumatology Department of Internal Clinic in Prishtina. Clinical response was assessed using American College of Rheumatology (ACR) criteria and the Disease Activity Score (DAS28) in 60 patients with RA. Radiographic changes were measured in the beginning and at the end of the study with Sharp Score.


Of total number of 60 patients (10 of them were males and 50 were females) with mean age of 57.63, 10 or 16.6% of patients were treated with combined therapy (ETN plus MTX) and 50 or 83.3% of patients with monotherapy (MTX). The group of combined therapy (ETN+MTX) after the treatment resulted with improvement of acute phase reactants as erythrocyte sedimentation rate (ESR) for the first hour (41.1 vs. 10.3 mm/hour) and C-reactive protein (CRP) (40.8 vs. 6 mg/liter) comparing to the group treated with MTX alone there were no significant changes (ESR: 45.7 vs. 34.3 mm/hour; CRP: 48 vs. 24 mg/liter). Before treatment the severity of the disease was high, where in group with combined therapy (ETN plus MTX) DAS28 was 5.32, and in the group with monotherapy of MTX DAS28 was 5.90. After 2 years of treatment we had significant changes in the results of DAS28, where in group treated with ETN plus MTX DAS28 was 2.12 ± 0.15, while in the group of patients treated with MTX DAS28 were 3.75 ± 0.39 (t = 13.03; df = 58; p < 0.0001). The group with combined therapy showed less radiographic progression comparing to the group of monotherapy (p < 0.05).


According to our results we can conclude that ETN in combination with MTX reduced disease activity, slowed radiographic progression and improved clinical manifestations more effectively than MTX alone within period of 2 years. During the treatment, no serious adverse events were noticed with combination treatment of ETN and MTX.


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