Etanercept

Etanercept Introduction

Etanercept is a biologic medication used to treat arthritis, plaque psoriasis, Crohn’s disease, psoriatic arthritis, and ankylosing spondylitis. It is a recombinant human TNF receptor protein in the form of an injectable solution. Etanercept is sold under the brand names Enbrel, Enbrel Sureclick, and Enbrel Mini. It is mainly a treatment that works by blocking tumor necrosis factor-alpha (TNF-alpha), which is a protein involved in inflammation. The drug allows a decrease in inflammation due to the inhibition of cytokines and immune cells.

Uses For Etanercept

Etanercept is prescribed for the treatment of a variety of inflammatory conditions including:

• Rheumatoid Arthritis
• Plaque Psoriasis
• Crohn’s Disease
• Psoriatic Arthritis
• Ankylosing Spondylitis

Brand Name	Etanercept
Type
Weight
Generic	Etanercept
Manufacturer
Available in	English বাংলা

Mechanism of Action

Etanercept is a soluble fusion protein that works by inhibiting TNF, a cytokine involved in inflammation. TNF is responsible for the death of cells and the release of inflammatory cytokines that promote cell death. By blocking these cytokines, Etanercept reduces inflammation and pain associated with the condition being treated. It also helps regulate the body’s immune system.

How Long Does It Take to Work

It usually takes up to four weeks for etanercept to start working. However, some people may experience symptom relief earlier than others. It is important to take the medication as directed by your doctor and to continue taking it even if you don't see improvement immediately.

Absorption

The absorption rate of etanercept is approximately 85%. The drug is rapidly and completely absorbed from the subcutaneous injection site.

Route of Elimination

Etanercept is eliminated from the body primarily by the kidneys. It is metabolized in the liver by the cytochrome P450 enzyme system.

Dosage

Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis: Patients aged 18 years or older- 50 mg Etanercept per week administered either once weekly (as one subcutaneous injection using a 50 mg syringe or as two 25 mg injections given at the same time) or 25 mg Etanercept twice weekly (72 to 96 hours apart) as a subcutaneous injection. Methotrexate, glucocorticoids, salicylates, nonsteroidal anti- inflammatory drugs (NSAIDs), or analgesics may be continued during treatment with Etanercept in adults. 25 mg once weekly gives a slower response and may be less effective.

Plaque psoriasis: The dose of etanercept is 50 mg syringe once weekly (as one subcutaneous injection using a 50 mg syringe or as two 25 mg injections given at approximately the same time) or 25 mg twice weekly (72 to 96 hours apart) as a subcutaneous injection. Higher responses may be achieved from initial treatment with a dose of 50 mg twice weekly for up to 12 weeks, followed, if necessary, by a dose of 50 mg once weekly or 25 mg twice weekly.

Adult patients may be treated intermittent or continuously based on physician judgment and individual patient needs. Treatment should be discontinued in patients who show no response after 12 weeks. With intermittent use, treatment cycles subsequent to the initial cycle should use a dose of 50 mg once weekly. No dose adjustment is required for elderly and or patient with renal and hepatic impairment. Patient weighs less than 62.5kg should be accurately dosed on an mg/kg basis. Patients weighing 62.5 kg or more may be fixed-dose prefilled syringe.

Juvenile idiopathic arthritis: Children (⩾2 to <18 years): 0.4mg/kg (up to maximum of 25 mg per dose) twice weekly (72 to 96 hours apart). Glucocoticoids, nonsteroidal anti-inflammatory drugs (NSAIDs), or analgesics may be continued during treatment with etanercept in children. Etanercept has not been studied in children <2 years of age.

Pediatric plaque psoriasis: Children (⩾6 to <18 years): 0.8mg/kg (up to a maximum of 50 mg per dose) once weekly for up to 24 weeks. Treatment should be discontinued in patients who show no response after 12 weeks. If retreatment of etanercept is indicated, the above guidance on treatment duration should be followed. The dose should be 0.8 mg/kg (up to maximum of 50 mg per dose) once weekly.

The dosage of etanercept varies depending on the condition being treated. People with plaque psoriasis typically receive 25 mg via subcutaneous injection twice per week for three months. People with rheumatoid arthritis who are over 18 years of age are usually prescribed 25 mg twice per week. For people with ankylosing spondylitis, the recommended dosage is 50 mg twice per week. The dose may be increased to 1 mg/kg/week based on the person’s response to treatment. It is important to take the medication as directed by your doctor and to continue taking it even if you don't see improvement immediately.

Administration

Etanercept is administered via subcutaneous injection. It is usually injected in the abdomen or thigh. The drug injection should be given at least 2 inches away from any infection sites. The drug should be taken as prescribed by the doctor and it is important to ensure that the patient follows the correct dosage and administration instructions.

Side Effects

Common side effects of etanercept include pain, redness, swelling, and infection at the injection site. Other side effects may include headaches, dizziness, diarrhea, nausea, and abdominal pain. These side effects usually fade away after a few days or weeks of use. In rare instances, more serious side effects can occur that require medical attention.

Toxicity

Etanercept is generally well tolerated. There have been no reports of serious toxicity associated with etanercept overdose. It is important to follow the doctor’s instructions and take the drug exactly as prescribed.

Precaution

Before taking etanercept, it is important to tell your doctor about any other medical conditions you have such as a history of heart disease, high blood pressure, or other immune system disorders. Tell your doctor if you are pregnant or breastfeeding. Etanercept should not be used in people with an active infection or in those who have recently had a vaccine.

Interaction

Etanercept may interact with certain drugs or supplements. It is important to tell your doctor and pharmacist about all the drugs and supplements you are taking so that any potential interactions can be avoided.

Disease Interaction

Etanercept may interact with certain diseases. It is important to tell your doctor about any pre-existing diseases you have. It may not be safe to take etanercept if you have active infections, leukemia, lymphoma, or multiple sclerosis.

Drug Interaction

Etanercept may interact with certain drugs such as methotrexate and warfarin. It is important to tell your doctor and pharmacist about all the drugs and supplements you are taking so that any potential interactions can be avoided.

Food Interactions

Etanercept does not interact with food. However, it is important to follow your doctor’s instructions for taking the medication.

Pregnancy Use

It is not recommended to use etanercept during pregnancy. The drug may pass through the placenta and can cause harm to a developing baby. If an expecting mother is using etanercept, she should contact her doctor and discuss the possible risks and benefits of using the medication.

Lactation Use

It is not known whether etanercept is excreted in human breast milk. Therefore, it is not recommended to use etanercept during breastfeeding.

Acute Overdose

There have been no reports of serious toxicity associated with etanercept overdose. In the event of an overdose, the patient should be closely monitored for symptoms and treated symptomatically.

Contraindication

It is important to inform your doctor if you have a history of anaphylaxis or a severe allergic reaction to etanercept or any of its components. It is also important to tell your doctor if you have an active infection or if you have recently had a vaccine.

Use Direction

Etanercept should be used exactly as prescribed by the doctor. It is important to follow the doctor’s instructions for taking the medication. It is also important to monitor for any side effects or adverse reactions.

Storage Condition

Etanercept should be stored at room temperature in a dry place and away from heat and light. It should be kept out of reach of children and pets. Do not freeze the solution and never use if the solution is discolored or cloudy.

Volume of Distribution

The distribution volume of etanercept is approximately 0.155 L/kg.

Half Life

The half-life of etanercept is approximately 15 hours.

Clearance

Etanercept is cleared from the body primarily by the kidneys. It is also metabolized in the liver by the cytochrome P450 enzyme system.

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