Jing S, et al. – This meta–analysis strived to assess the efficacy and safety of etanercept in patients with sciatica. This systematic review revealed that compared to placebo, etanercept treatment was correlated with a significantly reduced pain in leg and back and could possibly improve leg pain relief compared to steroids, but failed to improve Oswestry Disability Index (ODI). For sciatica, etanercept had to be recommended with caution due to heterogeneity.

• The physicians systematically searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases.
• They included randomized controlled trials (RCTs) and Controlled clinical trials (CCT) assessing the efficacy of etanercept on sciatica caused by lumbar disc herniation and spinal stenosis.
• For this study, 2 investigators independently searched articles, extracted data, and assessed the quality of included studies.
• The initial outcome was leg pain scores.
• Using random-effect model, meta-analysis was performed.

• The physicians included 4 RCTs and 1 CCT involving 184 patients in the meta-analysis.
• Etanercept could significantly reduce leg pain (Std. mean difference = -0.83; 95% CI = -1.59 to -0.06; P = 0.03) and back pain (Std. mean difference = -1.89; 95% CI = -3.34 to -0.43; P = 0.01) compared with placebo.
• However, they found no significant difference in the relief of leg pain (Std. mean difference = -1.18; 95% CI = -3.21 to 0.84; P = 0.25) and back pain (Std. mean difference = -0.29; 95% CI = -1.26 to 0.67; P = 0.55) when comparing etanercept to steroids.
• Compared with placebo (Std. mean difference = -0.83; 95% CI = -2.03 to 0.37; P = 0.18) and steroids (Std. mean difference = -0.19; 95% CI = -1.15 to 0.77; P = 0.70), etanercept demonstrated no increase in Oswestry Disability Index (ODI).