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What Does Enbrel Do For Rheumatoid Arthritis

Further Indications For Etanercept

Rheumatoid arthritis – causes, symptoms, diagnosis, treatment, pathology

TNF is an important inflammatory disease mediator in a wide spectrum of articular diseases, including RA, JRA, and PsA. Etanercept is an effective inhibitor of TNF, has been shown to provide rapid and sustained improvement in these diseases, and is an important new treatment option for patients with these conditions. Etanercept is currently being studied in other disorders in which TNF seems to play an important pathogenic part, including chronic heart failure, sarcoidosis, ankylosing spondylitis, and Wegener’s granulomatosis.

Enbrel Is The First Biologic To Publish Data Showing Safety And Sustained Efficacy For Up To Nine Years In Patients With Moderate

THOUSAND OAKS, Calif.—-Nov. 12, 2006–Amgen today announced that Enbrel is the firstbiologic with published data to show improvements in multiple measuresof efficacy that were sustained in rheumatoid arthritis patientscompleting up to nine years of therapy. These new data are beingpresented at the American College of Rheumatology ScientificMeeting in Washington, D.C.

“The current data in Rheumatoid Arthritis suggest that Enbrel isboth effective and safe in long-term use,” said Mark Genovese, M.D.,Stanford University Medical Center, Palo Alto, California. “Thesefindings are significant because they provide a degree of reassuranceto both the patient and the physician that unexpected safety concernsdo not appear to be developing after nine years of use.”

ENBREL continues to have a strong safety profile for extendedperiods of use. In the studies presented at ACR, rates of seriousadverse events and serious infections remained low and were consistentwith controlled portions from the double-blind phases of the studies.The overall number of observed malignancies were similar in type and number to what would beexpected in the general population.

“Before I was diagnosed with RA, the pain, stiffness and fatiguestopped me from doing many of the activities I enjoyed,” said GloriaTreece, a participant in the study. “Since starting ENBREL treatmentapproximately nine years ago, I’m now able to take part in manyactivities with my family.”

ABOUT RA

ABOUT ENBREL

About Amgen and Wyeth

What Should I Ask My Doctor

The sections above describe the typical dosages provided by the drug manufacturer. If your doctor prescribes Enbrel for you, theyll determine the dosage thats right for you.

Remember, you shouldnt change your dosage of Enbrel unless your doctor recommends it. You should use Enbrel exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Will my Enbrel dosage need to be changed if I have kidney disease?
  • Will my dosage be adjusted if my symptoms dont improve?
  • Is there a certain form of Enbrel that will work better for my condition?

You can sign up to receive our psoriasis or rheumatoid arthritis newsletters if you use Enbrel to treat either of these conditions.

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What Is The New Drug Used To Treat

Erelzi is given by injection. It can be used to treat the same diseases as Enbrel. That includes:

Nutritional Supplements And Dietary Changes

Rheumatoid Arthritis

Theres no strong evidence to suggest that specific dietary changes can improve rheumatoid arthritis, although some people with rheumatoid arthritis feel their symptoms get worse after they have eaten certain foods.

If you think this may be the case for you, it may be useful to try avoiding problematic foods for a few weeks to see if your symptoms improve.

But its important to ensure your overall diet is still healthy and balanced. A Mediterranean-style diet, which is based on vegetables, fruits, legumes, nuts, beans, cereals, grains, fish and unsaturated fats such as olive oil, is recommended.

Theres also little evidence supporting the use of supplements in rheumatoid arthritis, although some can be useful in preventing side effects of medicines you may be taking.

For example, calcium and vitamin D supplements may help prevent osteoporosis if youre taking steroids, and folic acid supplements may help prevent some of the side effects of methotrexate.

Theres some evidence to suggest that taking fish oil supplements may help reduce joint pain and stiffness caused by rheumatoid arthritis.

Further information

Page last reviewed: 28 August 2019 Next review due: 28 August 2022

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Enbrel For Other Conditions

In addition to the uses listed above, Enbrel may be used off-label to treat other conditions. Off-label drug use is when a drug thats approved for one use is used for a different one thats not approved.

Enbrel for eczema

Eczema is a skin condition that causes redness and itchy skin. Its not known exactly what causes eczema, but its believed to be a combination of genetics, an overactive immune system, and exposure to certain triggers.

There is very little information on the effectiveness of Enbrel to treat eczema. Some very small studies have shown improvement in people with eczema taking Enbrel. However, more studies are needed to determine if Enbrel is effective for treating eczema.

Enbrel for osteoarthritis

Enbrel is approved for the treatment of rheumatoid arthritis, which is a condition affecting your immune system. However, osteoarthritis is a different type of arthritis. Its caused by injury to the joint, overuse of the joint, or a lot of weight put on the joint. Osteoarthritis often occurs in your hips, knees, or spine.

Enbrel targets inflammation in your joints caused by an overactive immune system. Osteoarthritis isnt caused by an overactive immune system, so Enbrel isnt an effective treatment for osteoarthritis.

Enbrel for stroke

Is Enbrel An Nsaid

No, Enbrel is not an NSAID. Enbrel belongs to a class of medications called tumor necrosis factor blockers. TNF can cause inflammation in your body. Enbrel works by blocking this inflammation, which can help your condition improve. Enbrel can be taken along with NSAIDs for added benefit. Examples of NSAIDs include ibuprofen and naproxen . Talk with your doctor if youre interested in taking an NSAID with Enbrel.

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How Should I Use Enbrel

Before you start treatment with Enbrel, your doctor may perform tests to make sure you do not have an infection.

Enbrel is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don’t understand all instructions.

Do not shake this medicine. Prepare an injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.

You may need to mix Enbrel with a liquid . When using injections by yourself, be sure you understand how to properly mix and store the medicine.

Etanercept doses are based on weight in children. Your child’s dose needs may change if the child gains or loses weight.

If you need surgery, tell the surgeon ahead of time that you are using Enbrel.p

Enbrel affects your immune system. You may get infections more easily, even serious or fatal infections. Your doctor will need to examine you on a regular basis.

If you’ve ever had hepatitis B, using Enbrel can cause this virus to become active or get worse. You may need frequent liver function tests while using this medicine and for several months after you stop.

Carefully follow all storage instructions provided with your medicine.

When Will Enbrel Be Available In Generic Form

Rheumatoid Arthritis (RA) Signs & Symptoms (& Associated Complications)

There is no generic version of Enbrel on the market now. Some biosimilar alternatives have been approved in the last few years. These biosimilars, Erelzi and Eticovo, may end up being around 15% to 30% less expensive than Enbrel. They should come to market after patent issues are resolved. The timing for that is uncertain, but pharma industry executives say that Erelzi likely wont be available in the U.S. until 2029.

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Enbrel For Polyarticular Juvenile Idiopathic Arthritis

Enbrel is also approved to treat moderate to severe polyarticular juvenile idiopathic arthritis in children ages 2 years and older.

Polyarticular JIA is a type of arthritis that occurs in people younger than 18 years old. It causes swelling and pain in five or more joints. Its not known what causes polyarticular JIA.

Although polyarticular JIA may cause pain in any joint, the most commonly affected areas are small joints in the fingers and hands.

Enbrel works by decreasing the swelling in joints. This helps make it easier and less painful for children with polyarticular JIA to move their affected joints.

In clinical trials of children ages 2 to 17 years old with polyarticular JIA, 74% saw a decrease in symptoms after 3 months of taking Enbrel. After 3 months, children were split into two groups: those who continued to take Enbrel and those who started taking a placebo .

In the second part of the trial, about 77% of children taking a placebo had an arthritis flare-up. In comparison, 24% of children taking Enbrel had a flare-up. Children taking Enbrel didnt have their first flare-up of symptoms until at least 116 days after starting treatment. Children taking a placebo had their first flare-up 28 days after starting treatment.

Enbrel And Pain Medications

Enbrel may be used along with certain pain medications to help ease your symptoms. Sometimes conditions such as rheumatoid arthritis, ankylosing spondylitis, polyarticular JIA, and psoriatic arthritis may cause severe joint pain.

Examples of pain medications that may be used include tramadol and oxycodone . Combining Enbrel with these medications can help relieve pain.

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How Does Rheumatoid Arthritis Affect The Cervical Spine

Rheumatoid arthritis is a chronic inflammatory autoimmune condition. In autoimmune diseases, the immune system, which is supposed to fight infections and other harmful agents, mistakenly targets and attacks the bodys tissues. This results in chronic inflammation that causes damage to various tissues in the body, such as the joints, skin, eyes, heart, lungs, and kidneys.

The autoimmune attack in RA can target the bones of the spine, typically those in the neck or cervical region. This may cause three main types of abnormalities in the cervical spine:

  • Atlantoaxial instability: Most common abnormality seen in RA that affects the cervical spine. The atlantoaxial joint is the joint between the atlas and axis . This abnormality results in the misalignment of the two cervical vertebrae.
  • Superior migration of the odontoid: The odontoid process is a projecting bony part of the second cervical vertebra on which the first cervical vertebra rotates. This deformity can result in pressure on the lower part of the brain that may cause neurological dysfunction and even death in severe cases.
  • Subaxial subluxation: Least common type of cervical spine deformity. It can result in compression of the spinal cord.
  • Drug Forms And Administration

    Extraskeletal Manifestations in Rheumatoid Arthritis

    Enbrel and Humira are available in different forms. Both drugs are given as subcutaneous injections.

    For Enbrel

    Enbrel is available in the following forms:

    • prefilled syringe
    • prefilled SureClick autoinjector
    • powder to be mixed into a solution
    • Enbrel Mini single-dose prefilled cartridge

    Enbrel is given as a subcutaneous injection, usually once a week. If you have rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis, the standard Enbrel dose is one 50-mg injection every week.

    For adults with plaque psoriasis, you may start out with a dose of 50 mg twice per week for the first 3 months. After that, youll likely reduce your dose to one 50-mg dose a week.

    For children with either plaque psoriasis or juvenile idiopathic arthritis, the dosage is usually based on weight. Children who weigh 138 pounds or more will receive one 50-mg injection each week.

    Children who weigh less than 138 pounds also receive one injection each week. The dose is based on weight. The milligram strength is calculated as 0.8 mg/kg.

    For example, if a child weighs 42 pounds, that equals about 19 kg. The dose is calculated as 19 kg multiplied by 0.8 mg/kg, resulting in a dose of about 15 mg. Your childs doctor or pharmacist can calculate the correct dosage for you.

    For Humira

    Humira is available in the following forms:

    • single-use prefilled syringe
    • single-use prefilled pen
    • single-use 40-mg vial

    Much like Enbrel, the pediatric dose of Humira for polyarticular JIA is based on the childs weight:

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    How Is Enbrel Administered

    Enbrel is administered by subcutaneous injection .

    It is usually administered once or twice a week, depending on the condition being treated, for example:

    • Adult rheumatoid arthritis, Ankylosing spondylitis, and Psoriatic arthritis: 50mg once weekly
    • Psoriasis: 50mg twice weekly for three months then once weekly thereafter.

    Enbrel can either be administered by a physician or nurse or people needing it can be taught how to self-administer.

    • Enbrel Immunex Corporation
    • Hubert Marotte & Rolando Cimaz Etanercept â TNF receptor and IgG1 Fc fusion protein: is it different from other TNF blockers?, Expert Opinion on Biological Therapy, 14:5, 569-572, DOI: 10.1517/14712598.2014.896334

    How To Inject Enbrel

    Enbrel is a medication thats given as a subcutaneous injection. Youll probably get your first dose of Enbrel in your doctors office. Then your doctor or pharmacist may show you how to inject Enbrel so you can use the medication at home.

    You should take Enbrel according to your doctor or healthcare providers instructions. The Enbrel website also provides step-by-step instructions and videos on how to use each Enbrel product.

    Here are some other tips for using Enbrel:

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    Before Taking This Medicine

    You should not use Enbrel if you are allergic to etanercept, or if you have a severe infection such as sepsis .

    To make sure Enbrel is safe for you, tell your doctor if you have:

    • a weak immune system, HIV or AIDS, tuberculosis, or any type of recurring infection

    • symptoms of an active infection such as fever, flu symptoms, diarrhea, or painful urination

    • an open cut or skin sores

    • a history of nerve disorders such as multiple sclerosis, Guillain-Barré syndrome, myelitis, or optic neuritis

    • epilepsy or other seizure disorder

    • asthma or other breathing disorder

    • if you have ever had hepatitis B

    • if you are allergic to latex rubber or

    • if you are scheduled to receive any vaccines, or if you have recently been vaccinated with BCG .

    Tell your doctor if you have ever had tuberculosis, were exposed to tuberculosis indicated by a positive PPD test, if anyone in your household has tuberculosis, or if you have recently traveled to an area where certain infections are common .

    Children should be current on all childhood immunizations before starting treatment with Enbrel.

    Using Enbrel may increase your risk of developing certain types of cancer, including a fast-growing lymphoma that can be fatal. This rare lymphoma has occurred in male teenagers and young men using a combination of immunosuppressant medicines to treat Crohn’s disease or ulcerative colitis. However, people with autoimmune disorders may have a higher risk of lymphoma. Talk to your doctor about your individual risk.

    How Are Enbrel And Humira Alike And Different

    What is Rheumatoid Arthritis? | Johns Hopkins Rheumatology

    Both Enbrel and Humira are biologic medications. Biologic medications are made from living cells. Enbrel and Humira are also both injections. And they work by lowering the activity of your immune system.

    These two drugs target the same part of your immune system. They both block the activity of a protein called tumor necrosis factor .

    These drugs also share the same side effects. And both have for serious infections and cancer. Boxed warnings alert people to serious side effects of a drug. These are the most serious warnings about a drugs side effects.

    Both Enbrel and Humira can be used to treat:

    Doctors can prescribe Enbrel for adults and some children with plaque psoriasis. But Humira can only be used to treat plaque psoriasis in adults.

    If youd like to know more about the differences and similarities of these two drugs, talk with your doctor.

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    What Is Enbrel Used For

    Enbrel is approved to treat the following conditions:

    • Rheumatoid arthritis
    • Plaque psoriasis in adults and children who are at least 4 years old
    • Psoriatic arthritis
    • Ankylosing spondylitis
    • Polyarticular juvenile idiopathic arthritis in children who are at least 2 years old.

    It is sometimes used in combination with methotrexate when used to treat rheumatoid arthritis and psoriatic arthritis.

    Can I Use Nsaids Together With Enbrel To Treat Psoriatic Arthritis

    As long as your doctor approves, its safe to take nonsteroidal anti-inflammatory drugs with Enbrel. There arent any known drug interactions between Enbrel and NSAIDs.

    When taken for psoriatic arthritis, NSAIDs may help relieve joint swelling and morning stiffness, and they may help improve joint range of motion. Examples of NSAIDs include:

    Although many NSAIDs are available over the counter, its very important that you dont take these medications with Enbrel without first talking with your doctor. Your doctor can work with you to determine the best treatments for your psoriatic arthritis.

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    Enbrel 25 Mg Powder And Solvent For Solution For Injection

    This information is intended for use by health professionals

    Enbrel 25 mg powder and solvent for solution for injection

    Each vial contains 25 mg of etanercept.

    Etanercept is a human tumour necrosis factor receptor p75 Fc fusion protein produced by recombinant DNA technology in a Chinese hamster ovary mammalian expression system.

    For the full list of excipients, see section 6.1.

    Powder and solvent for solution for injection .

    The powder is white. The solvent is a clear, colourless liquid.

    Rheumatoid arthritis

    Enbrel in combination with methotrexate is indicated for the treatment of moderate to severe active rheumatoid arthritis in adults when the response to disease-modifying antirheumatic drugs, including methotrexate , has been inadequate.

    Enbrel can be given as monotherapy in case of intolerance to methotrexate or when continued treatment with methotrexate is inappropriate.

    Enbrel is also indicated in the treatment of severe, active and progressive rheumatoid arthritis in adults not previously treated with methotrexate.

    Enbrel, alone or in combination with methotrexate, has been shown to reduce the rate of progression of joint damage as measured by X-ray and to improve physical function.

    Juvenile idiopathic arthritis

    Treatment of polyarthritis and extended oligoarthritis in children and adolescents from the age of 2 years who have had an inadequate response to, or who have proved intolerant of, methotrexate.

    Psoriatic arthritis

    Axial spondyloarthritis

    Plaque psoriasis

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