What is etanercept? What is etanercept used for?
Etanercept is an injectable drug that is used for treating rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and plaque psoriasis.
It works by blocking tumor necrosis factor alpha (TNF alpha). Other drugs that block TNF alpha include adalimumab (Humira), certolizumab (Cimzia), golimumab (Simponi), and infliximab (Remicade).
TNF alpha is a protein that the body produces during when there is inflammation, the body's reaction to injury. TNF alpha promotes inflammation and its associated fever and signs (pain, tenderness, and swelling) in several inflammatory conditions including rheumatoid arthritis and ankylosing spondylitis. Etanercept is a synthetic (man-made) protein that binds to TNF alpha. It thereby acts like a sponge to remove most of the TNF alpha from the joints and blood. This prevents TNF alpha from promoting inflammation and the fever, pain, tenderness, and swelling of joints in patients with rheumatoid or psoriatic arthritis and ankylosing spondylitis. Etanercept prevents the progressive destruction of the joints in patients with rheumatoid arthritis and the arthritis of psoriasis. The FDA approved etanercept in November 1998.
What brand names are available for etanercept?
Enbrel
Is etanercept available as a generic drug?
No
Do I need a prescription for etanercept?
Yes
What are the side effects of etanercept?
The most common side effects are:
- mild to moderate itching,
- pain,
- swelling and redness at the site of injection,
- headache,
- dizziness,
- nasal and throat.
TNF alpha has an important role in the responses of the immune system to
infections. Thus, blocking the action of TNF alpha with etanercept may worsen or
increase the occurrence of infections such as tuberculosis,
bacterial sepsis,
invasive fungal infections (such as histoplasmosis), and other opportunistic
infections (infections that occur primarily in patients with suppressed immune
systems). Patients with serious infections should not receive etanercept, and
etanercept should be discontinued if a patient develops a serious infection.
Etanercept should be used with caution in patients prone to infection, such as
those with advanced or poorly controlled diabetes. Children should receive their
recommended immunizations before treatment with etanercept.
Some reported associated conditions may or may not be related to etanercept.
Other important side effects include:
- cancer,
- multiple sclerosis,
- myelitis, and
- optic neuritis.
For this reason, etanercept is not recommended for persons with preexisting disease
of the central nervous system (brain and/or spinal cord) or for those with
multiple sclerosis, myelitis, or optic neuritis. Additionally, rare cases of
seriously low blood counts (pancytopenia) have been reported in patients using
etanercept. New cases or worsening of congestive heart failure may occur.
What is the dosage for etanercept?
Etanercept is injected under the skin.
- Adult rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis:
50 mg weekly - Plaque psoriasis: 50 mg twice weekly for 3 months, followed by 50 mg once
weekly - Juvenile rheumatoid arthritis: 0.8 mg/kg weekly, with a maximum of 50 mg
per week
Which drugs or supplements interact with etanercept?
Because etanercept may reduce the response of the immune
system, etanercept should not be administered with live vaccines. Combining
etanercept with anakinra (Kineret) or abatacept (Orencia), drugs that also
reduce the response of the immune system may increase the risk of serious
infections.
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Is etanercept safe to take if I’m pregnant or breastfeeding?
Studies have not been conducted in
pregnant women. Animal studies
using doses 60-100 times human doses did not reveal toxicity to the fetus. Since
animal studies are not always predictive of human response, etanercept is only
used in pregnant women when there is a clear need.
It is unknown whether etanercept is excreted in human
breast
milk. Because of the risk of serious effects in the infant, a decision should be
made whether to discontinue nursing or etanercept.
What else should I know about etanercept?
What preparations of etanercept are available?
25 mg multiple use vial; 25 or 50 mg prefilled syringe; 50 mg
prefilled autoinjector.
How should I keep etanercept stored?
Sterile powder and pre-filled syringes should be refrigerated at
2 C to 8 C (36 F to 46 F). Reconstituted solutions made from the powder should be used as
soon as possible but may be stored in the vial at 2 C – 8 C (36 F – 46 F) for 14 days.