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

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.