Enbrel

Indications

Etanercept is a biological medicine used to treat moderate to severe rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and other forms of axial spondyloarthritis, plaque psoriasis, and some forms of juvenile idiopathic arthritis in children. It is often used when other treatments such as Methotrexate have not worked well enough, and may be combined with Methotrexate.

How It Works

Etanercept is a laboratory-made fusion protein that acts like a decoy receptor for tumour necrosis factor (TNF). TNF is a messenger protein that drives inflammation in joints and skin. By binding TNF, etanercept stops it from acting, which reduces pain, swelling, stiffness, skin plaques and joint damage.

Dosage and Administration

Etanercept is given as an injection under the skin, usually once or twice a week, at the dose prescribed by the specialist. The first injections may be given by a nurse; after training, many patients inject themselves using a prefilled syringe or pen in the thigh, abdomen or upper arm, changing the site each time. Children's doses are based on weight. Allow the injection to reach room temperature for about 15 to 30 minutes before use.

Interactions

Do not combine with Anakinra or Abatacept, as the risk of serious infection rises. Use with Sulfasalazine may lower white blood cells. Live vaccines must not be given during treatment. Tell your doctor about all medicines, including other immune-suppressing treatments.

Contraindications

Do not use if you are allergic to Etanercept or any ingredient, if you have sepsis or are at risk of it, or if you have an active infection, including tuberculosis.

Side Effects

Common effects include injection-site reactions (redness, itching, swelling, pain), upper respiratory infections, headache, and allergic reactions such as rash. Serious but uncommon effects include serious infections (including tuberculosis and fungal infections), reactivation of hepatitis B, nerve problems such as multiple sclerosis-like symptoms, heart failure worsening, blood disorders, lupus-like syndrome and some cancers including skin cancer and lymphoma.

Get urgent medical help if you have fever, chills, persistent cough, night sweats or weight loss; unusual bruising, bleeding or paleness; numbness, weakness or vision problems; shortness of breath or swollen ankles; or a severe allergic reaction with swelling of the face or throat or difficulty breathing.

Pregnancy and Lactation

Use in pregnancy only if clearly needed, after discussion with the specialist. If used in pregnancy, the baby should not receive live vaccines for a period after birth, as advised by the doctor. Small amounts pass into breast milk; the doctor will advise on breastfeeding.

Precautions and Warnings

You will be tested for tuberculosis and hepatitis B before starting. Tell the doctor about recurring infections, diabetes, heart failure, nerve diseases, blood disorders, cancer history or alcohol-related hepatitis. Use sun protection and have regular skin checks. Report any infection early, as this medicine can make infections more serious.

Overdose

No specific toxic effects are known from higher doses. If too much is injected, contact your doctor for advice and monitoring.

Therapeutic Class

Tumour necrosis factor (TNF) inhibitor (biological immunosuppressant)

Storage

Store in a refrigerator at 2 to 8°C, do not freeze, keep in the outer carton to protect from light, and keep out of the reach of children. It may be kept at room temperature (up to 25°C) for a limited time if the pack allows; follow the label.