Etanercept - Enbrel

What is Enbrel?
Enbrel is a biologic medication approved by the European Agency for the Evaluation of Medicinal Products (EMEA) for the treatment of moderate to severe psoriasis and for the treatment of psoriatic arthritis.

Key Features;
• Approved for treating psoriasis and psoriatic arthritis.
• Patients give themselves an injection under the skin twice per week.
• It is taken continuously to maintain results.
• Minor allergic -like reactions can occur where the injection is given.

How does it work?
Enbrel blocks tumour necrosis factor-alpha (TNF alpha) a ‘chemical’ messenger in the immune system that signals other cells to cause inflammation. There is too much TNF alpha in the skin of people with psoriasis and the joints of people with certain types of arthritis which causes inflammation and can lead to tissue and joint damage. TNF-alpha can also lead to increased immune system activity through the activation of T cells. T Cells are a type of white blood cell in the body, in psoriasis, once T cells are mistakenly activated they can trigger inflammation and other immune responses and fuel the development of psoriasis lesions.
Enbrel helps lower the amount of TNF alpha to more normal levels thus interrupting the inflammatory cycle of psoriasis and psoriatic arthritis and leading to improvement in symptoms for many people who take it.
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Who is it for?
Enbrel is indicated for the treatment of active and progressive psoriatic arthritis in adults when the response to previous disease modifying anti-rheumatic drug therapy has been inadequate.
It is also indicated for the treatment of adults with severe plaque psoriasis who failed to respond to, or have a contraindication to, or are intolerant to other systemic therapy including ciclosporin, methotrexate or PUVA.

Who should not take Enbrel?
People with active infections should not start Enbrel.
The use of Enbrel in pregnant women is not recommended and women of child bearing potential should be advised not to get pregnant during Enbrel therapy.

How is it used?
Patients take Enbrel at home by giving themselves an injection under the skin, similar to diabetes patients. Two injections are to be given per week. The medication, equipment and information will be delivered to patients at home by a nurse from Health Care at Home who will give full instructions.
Enbrel can be prescribed by itself or as a combination treatment with methotrexate.
Enbrel is designed to be taken until "remission" is achieved, for up to 24 weeks.
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What are the side effects?
In the arthritis studies the most common side effects reported were – dizziness, sore throat,cough,stomach pain,injection site reactions,upper respiratory infections,headache,rhinitis (irritation of the nose).
These side effects are generally mild and did not cause most patients to stop taking Enbrel. These events happened most often after the first dose of Enbrel and may decrease after additional doses. Some serious side effects have been reported in the clinical trials.
The medication should not be started in someone with an active infection and it may not be recommended for someone with a history of recurring infections. If a serious infection occurs a doctor will most likely stop Enbrel.

How do I get Enbrel?
Enbrel will only be prescribed by a Consultant Dermatologist in a hospital dermatology department. It will only be prescribed for those patients for whom all other treatments have failed or are contraindicated.

N.B. Enbrel is also indicated for the treatments of active and progressive rheumatoid arthritis in adults, severe ankylosing spondylitis and active polyarticular – course juvenile chronic arthritis in children aged 4-17 years.
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