A randomized, double blind, placebo-controlled trial to evaluate the clinical efficacy and the structure modifying properties of etanercept 50/25 mg sc weekly in patients with erosive OA of the interphalangeal finger joints.

1. Males and females > 18 years of age;

2. Subjects with inflammatory erosive hand OA;

3. At least 4 OA nodes of the IPJs;

4. At least 1 inflamed IP;

5. At least 1 IP with positive power Doppler signal at ultrasound;

6. At least 1 IPJ has the typical appearance on radiograph of a ‘J’or ‘E’ phase joint;

7. OA pain at rest > 30 mm on the VAS;

8. Flare of OA pain with activity at baseline (after NSAID washout) as defined by: >50mm on the VAS;

9. Worsening by > 20 mm on the VAS compared to screening;

10. Use of NSAIDs for finger joint pain at least 5 days per week with a stable dose for at least 4 weeks;

11. Inadequate response to at least 1 NSAIDS other than the current NSAID;

12. Able and willing to self-administer sc injections or have available a suitable person to administer sc injections;

13. Able and willing to give written informed consent and to comply with the requirements of the study protocol.

1. Prior treatment with any investigational agent within 30 days, or five half lives of the product, whichever is longer;

2. Patients suffering from chronic inflammatory rheumatic disease;

3. All subjects who are not surgically sterile or postmenopausal must agree and commit to the use of a reliable method of birth control for the duration of the study and for 30 days after the last dose of test article;

4. Stable dosage for at least 3 months with chondroitin sulfate, glucosamine, biphosphonate, corticosteroids, tetracyclines and estrogens is allowed;

5. Prior use of any immunomodulating drug with possible effects on pro-inflammatory cytokine metabolism within 90 days a.o. corticosteroids, methotrexate, sulfasalazine, leflunomide, d-penicillamin, anti-malarials, cytotoxic drugs, TNF blocking agents;

6. If the patient is of child-bearing age, he/she must use effective means of contraception during the study;

7. Patient who has a known blood coagulation disorder;

8. History of cancer or lymphoproliferative disease other than a successfully and completely treated squamous cell or basal cell carcinoma of the skin or cervical dysplasia, with no recurrence within the last two years;

9. Comorbidities: uncontrolled diabetes, unstable ischemic heart disease, congestive heart failure (NYHA III, IV), active inflammatory bowel disease, recent stroke, chronic leg ulcer and any other condition which, in the opinion of the investigator, would put the subject at risk by participation in the protocol;

10. Positive serology for hepatitis B or C indicating active infection;

11. History of positive HIV status;

12. Persistent or recurrent infections or severe infections requiring hospitalization or treatment with iv antibiotics within 30 days, or oral antibiotics within 14 days prior to enrollment;

13. Female subjects who are breast-feeding;

14. History of clinically significant drug or alcohol abuse in the last year;

15. Previous diagnosis or signs of central nervous system demyelinating diseases (e.g., optic neuritis, visual disturbance, gait disorder/ataxia, facial paresis, apraxia);

16. Medical history of systemic lupus erythematosus or other connective tissue disease, RA, reactive arthritis, psoriasis;

17. Evolutive tuberculosis or other severe infections like sepsis and opportunistic infections;

18. Patients with latent TB or having other risk factors for activation of latent TB, who have not initiated a TB prophylaxis prior to the first etanercept treatment;

19. Current or prior history of blood dyscrasias. Abnormal safety baseline blood test;

20. Pre-existing or recent onset CNS demyelinating disease;

21. Uncontrolled conditions, e.g., diabetes mellitus, hypertension, severe pulmonary disease requiring hospitalization or supplemental oxygen;

22. Latex sensitivity;

23. Reasonable expectation that the subject will not be able to satisfactorily complete the study. History of or current psychiatric illness, alcohol or drug abuse that would interfere with the subject’s ability to comply with protocol requirements or give informed consent;

24. Employment by the investigator or reporting directly or indirectly to the investigator.