We aimed to evaluate the efficacy and safety of long-term use of
etanercept therapy in patients with
spondyloarthropathy (SpA) and
rheumatoid arthritis (RA) on
hemodialysis (HD). Selected RA or SpA patients treated with
etanercept under HD were retrospectively evaluated.
Etanercept-related adverse events were closely recorded for all patients. At the follow-up, erythrocyte sedimentation rate and
C-reactive protein levels were monitored. Bath
Ankylosing Spondylitis Disease Activity Index (BASDAI) for SpA patients and Disease Activity Score (DAS28) for RA patients were measured at every 3 or 6 months. In total five
end-stage renal disease (
ESRD) patients were enrolled to the study. The causes of
ESRD in the study subjects were
amyloidosis (n = 2),
analgesic nephropathy (n = 2), and
nephrolithiasis (n = 1). Three were diagnosed as SpA and two were RA. All patients used
etanercept. The median age was 39 years (range 22-72 years). The median disease duration was 12 years (range 2-20 years). The median follow-up after
etanercept therapy was 18 months (range 5-33 months). DAS28 score decreased after the treatment and did not increase during follow-up in RA patients. BASDAI score decreased after the treatment during follow-up in three patients with SpA. At the follow-up, only one patient was diagnosed with
septic arthritis. As a result of our study,
etanercept treatment in RA and SpA patients on HD seems to be safe, well tolerated, and effective in most of the patients. Above all, due to impaired host defense in patients with
ESRD, enhanced risk of
infections should be kept in mind during follow-up period and larger trials are needed to prove the safety of
etanercept in HD patients.