Etanercept
Etanercept is a ‘biologic’ drug. Biologic drugs are often referred to as ‘targeted therapies’ because they work on specific cells of the immune system. Etanercept works on the TNFα cells.
Other names
Enbrel (originator); Benepali, Elrezi (biosimilars)
Type of JIA
ALL
How is it taken?
Injection
How often?
Once or twice a week
How long for?
Long term
How soon does it start working?
From two to 12 weeks
Background
Etanercept has been used in JIA since the late 1990s and approved for use in the UK in 2003.
Usage
Etanercept may be prescribed together with methotrexate, as the combination of drugs enables better control of JIA. Etanercept may be used on its own if the child or young person experiences side effects with methotrexate that they are no longer able to cope with.
Precautions
DO NOT ADMINISTER abatacept, adalimumab, canakinumab, etanercept or tocilizumab to a child or young person if they have a high temperature of 38°C or above or you are concerned that they are unwell with an infection (don’t worry if they just have a minor cough or cold) – seek medical advice from your GP or child’s healthcare team.
Blood tests
Are performed to make sure there are no problems with cell counts. This is the same as for sDMARDs but the tests are performed much less often (typically every six months). Your child’s healthcare team will talk to you about this and any other test they need to arrange.
Vaccinations
‘Live’ vaccines – measles, mumps, rubella (MMR), chickenpox, oral polio (NOT injectable polio), BCG, oral typhoid and yellow fever – cannot be given to anyone already taking a biologic DMARD. If biologic treatment has not yet been started, it is important to seek advice on how long a gap to leave after having a live vaccine.
Other medicines
There are currently no specific prescribed medicines to be avoided when taking bDMARDs. But take care when using any other medications or complementary therapies (even if bought ‘over the counter’ for coughs, colds or flu). Check with a doctor, nurse or pharmacist that they are safe.
Alcohol
Alcohol can be consumed when taking bDMARDs such as abatacept, adalimumab, canakinumab, etanercept and tocilizumab. However, caution may be required when taking other medications – methotrexate, for example – alongside biologics.
Pregnancy
There is not enough research information to give advice that either pregnancy or breastfeeding are safe while taking bDMARDs, and reliable contraception should be considered if sexually active.
Tattoos and body piercings
When taking a bDMARD, there may be an increased risk of skin infection associated with the tattooing. It is therefore important to consider this and where the tattoo is being performed. If the skin becomes particularly red more than 24 hours afterwards and/or a fever is developed, you may need antibiotics.
Updated: 01/07/2021