A new type of anti-inflammatory pain medicine injected into the spine has been found to be less effective at relieving the severe leg and lower back pain of sciatica than steroids, a Johns Hopkins-led study has found.
The research, published in the Annals of Internal Medicine, is the first to do a head-to-head comparison of standard sciatica treatment and the newly developed etanercept – brand name: Enbrel -- a genetically engineered small-protein drug known as a tumor necrosis factor inhibitor (TNF).
Enbrel is currently used to treat rheumatoid arthritis and other autoimmune disorders that cause pain, swelling and damage by blocking inflammation.
Doctors had hoped the drug would be effective in treating sciatica, but research led by Dr. Steven P. Cohen, of the Johns Hopkins University School of Medicine, found patients receiving epidural injections of steroids had less pain and disability than those injected with Enbrel or saline.
Cohen said the study aimed to determine if etanercept could prevent or limit the pain from a herniated disc pressing on a nerve root in the lower back or neck. Steroids work, he said, but can have mixed or temporary, and may cause complications.
"People are desperate for a safer, more effective drug," Cohen said. "This new treatment shows a lot of promise, but at least in the doses we gave it — the dose known to be safe — steroids still work better. And in those lower doses, etanercept may not be the drug everyone's hoping it is. There's still a lot more work to be done."