Evaluating the Tolerability and Efficacy ofEtanercept Compared to TriamcinoloneAcetonide for the Intralesional Treatment ofKeloids

August 2008 | Volume 7 | Issue 8 | Original Article | 757 | Copyright © August 2008

Bruce Berman MD PhD, Jitendrakumar K. Patel MD,Oliver A. Perez MD, Martha H. Viera MD, Sadegh Amini MD,Samantha Block, Deborah Zell MD, Sujatha Tadicherla MD,Adriana Villa MD, Claudia Ramirez MD, Tami De Araujo MD

Abstract

Background: Tumor necrosis factor-alpha (TNF-α) is a proinfl ammatory and profi brotic cytokine that inhibits degradation of collagen and glycosaminoglycans. Etanercept, a recombinant TNF-α receptor fusion protein, may decrease excessive fi brous tissue in keloids.
Objective: To evaluate the tolerability and effi cacy of etanercept as compared to triamcinolone acetonide (TAC) for the treatment of keloids.
Methods: Twenty subjects were randomly assigned to receive monthly intralesional injections of either 25 mg of etanercept or 20 mg of TAC for 2 months. Keloids were evaluated at baseline, week 4, and week 8 by subjects and investigators in a blinded fashion using physical, clinical, and cosmetic parameters. Photographs were taken and adverse events were noted during each evaluation.
Results: Etanercept improved 5/12 parameters including signifi cant pruritus reduction, while TAC improved 11/12 parameters at week 8, although no statistical difference was observed as compared to baseline. There was no signifi cant difference between the 2 treatment groups. Both treatments were safe and well tolerated.
Conclusion: Etanercept was safe, well tolerated, improved several keloid parameters, and reduced pruritus to a greater degree than TAC therapy. However, further studies are required before it can be recommended for the treatment of keloids.