If Dr. Tobinick was really interested in how etanercept worked he would be all over this research and publishing his own articles on etanercept. But I bet he will do nothing on this. You can draw your own conclusion from his lack of clinical trials on his use of etanercept.
http://www.medpagetoday.com/Rheumatology/Arthritis/55798?
Treatment with tumor necrosis factor (TNF) inhibitors was not
associated with an increased risk of ischemic stroke in patients with
rheumatoid arthritis (RA), a British study found.
Compared with RA patients receiving conventional disease-modifying
anti-rheumatic drugs (DMARDs), there was no significant association
between the risk of a first ischemic stroke and ever-exposure to
anti-TNF therapy (HR 0.99, 95% CI 0.54-1.81), according to Kimme Hyrich, MD, PhD, of the University of Manchester, and colleagues.
And
although the numbers were small, there was a trend toward a reduced
mortality among patients receiving a TNF inhibitor at the time of their
ischemic stroke compared with those who had never received a biologic,
the researchers reported online in Arthritis & Rheumatology.
TNF alpha is a key driver of inflammation, which is believed to be
involved in the atherosclerotic process leading to ischemic stroke. Previous studies
showed that inhibition of TNF alpha does not influence the occurrence
of ischemic stroke compared to DMARD therapy, but only in the short
term.
More at link.
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