etanercept


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Related to etanercept: infliximab

etanercept

 [e-tan´er-sept]
a soluble tumor necrosis factor receptor that inactivates tumor necrosis factor, used in treatment of rheumatoid arthritis; administered subcutaneously.

etanercept

Enbrel

Pharmacologic class: Immunomodulator

Therapeutic class: Antiarthritic

Pregnancy risk category B

Action

Reacts with and deactivates free-floating tumor necrosis factor, responsible for inflammation

Availability

Powder for injection: 25 mg in multiple-use vial

Prefilled syringe (single-use): 50 mg/ml

Indications and dosages

Moderately to severely active rheumatoid arthritis; ankylosing spondylitis; psoriatric arthritis

Adults: 50 mg subcutaneously q week given as a single injection. Dosages above 50 mg/week are not recommended.

Chronic moderate to severe plaque psoriasis

Adults ages 18 and older: 50 mg subcutaneously twice weekly (given 3 or 4 days apart) for 3 months, followed by reduction to a maintenance dosage of 50 mg weekly

Polyarticular-course juvenile rheumatoid arthritis

Children ages 4 to 17: 0.8 mg/kg subcutaneously q week, to a maximum of 50 mg weekly

Contraindications

• Hypersensitivity to drug or its components

• Sepsis

Precautions

Use cautiously in:

• immunosuppression, chronic infection, heart failure

• latex allergy (needle cover of diluent syringe contains latex)

• elderly patients

• pregnant or breastfeeding patients

• children younger than age 4.

Administration

• Inject subcutaneously into thigh, abdomen, or upper arm.

• For adult, use single-use, 50 mg/ml prefilled syringe.

• For child weighing 63 kg (138 lb) or more, use single-use, 50 mg/ml pre-filled syringe for weekly dose; for child weighing 31 to 62 kg (68 to 137 lb), administer total weekly dose from multipleuse vial as two injections on same day or 3 or 4 days apart; for child weighing less than 31 kg (68 lb), give as a single weekly injection using multipleuse vial.

• Rotate injection sites.

Adverse reactions

CNS: asthenia, headache, depression, dizziness, paresthesia, fatigue, demyelinating disorders (such as multiple sclerosis and myelitis), cerebral hemorrhage, seizures, cerebrovascular accident (CVA)

CV: hypotension, hypertension, chest pain, deep-vein thrombosis, thrombophlebitis, myocardial ischemia, myocardial infarction (MI), heart failure

EENT: ocular inflammation, pharyngitis, rhinitis, sinusitis

GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, anorexia, cholecystitis, abdominal abscess, GI hemorrhage, intestinal perforation, pancreatitis

GU: pyelonephritis, membranous glomerulonephropathy

Hematologic: anemia, aplastic anemia, leukopenia, pancytopenia, thrombocytopenia

Metabolic: hypomagnesemia

Musculoskeletal: bursitis, polymyositis, joint pain

Respiratory: cough, congestion, dyspnea, bronchitis, pneumonia, pulmonary embolism, interstitial lung disease

Skin: flushing, cellulitis, pruritus, rash, cutaneous vasculitis, urticaria, alopecia, angioedema

Other: altered taste, weight gain, adenopathy, fever, irritation at injection site, peripheral edema, flulike symptoms, autoantibody formation, lupus-like syndrome, serious infections, malignancies

Interactions

None significant

Patient monitoring

Watch for signs and symptoms of malignancies, pancytopenia and infection.

Monitor for evidence of GI bleeding, lupus-like syndrome, and serious hypersensitivity reactions. Stop therapy immediately if these occur.

• Monitor CBC and coagulation studies.

Check for signs and symptoms of cardiac compromise and cerebrovascular events.

• Monitor pulmonary function test results periodically to assess lung status.

• Assess patient's ability to self-administer drug.

• Check for irritation at injection site. As needed, apply cool compresses.

• Examine eyes for conjunctival dryness. As needed, apply artificial tears.

Patient teaching

Tell patient to withhold dose and contact prescriber if he develops signs or symptoms of infection or is exposed to anyone with chickenpox.

Tell patient to immediately report hypersensitivity reaction, neurologic or respiratory problems, sudden weight gain, chest pain, or easy bruising or bleeding.

• Teach patient or caregiver how to administer drug and handle and dispose of equipment.

• Caution patient not to get live-virus vaccines.

• Tell female to inform prescriber if she is pregnant or breastfeeding.

• Advise patient to expect redness, swelling, and pain at injection site. Assure him that these problems will diminish over time.

• As appropriate, review all other significant and life-threatening adverse reactions mentioned above.

etanercept

(ĭ-tăn′ər-sĕpt′)
n.
A drug that blocks tumor necrosis factor receptors and is used to treat autoimmune diseases, especially rheumatoid arthritis and psoriasis.

etanercept

Molecular medicine A genetically engineered molecule that blocks TNF activity, used to manage therapeutically refractive rheumatoid arthritis. See Rheumatoid arthritis.

etanercept

A fusion protein for the human tumour necrosis factor (TNF) receptor produced by recombinant DNA technology and engineered to block the action of TNA. It is used to treat RHEUMATOID ARTHRITIS. The drug has been claimed to relieve depression and fatigue in PSORIASIS. A brand name is Enbrel.
References in periodicals archive ?
Immunex/Amgen and Sandoz have entered into an agreement with respect to a preliminary injunction regarding Sandoz's etanercept as set out in the Court's order of June 7, 2018.
"This study established that there is an increased risk of developing inflammatory bowel disease in individuals taking etanercept. Recognition of this phenomenon is important for clinicians taking care of these patients," Korzenik said in a statement.
The secondary endpoint of minimal disease activity response at week 24 also was significantly greater in the etanercept monotherapy and combination groups than in the methotrexate monotherapy group (35.9% and 35.7% vs.
The Medline literature database was searched through PubMed using the key words, individually and in combination: 'human immunodeficiency virus', 'cutaneous inflammatory diseases', 'inflammatory skin disorders', 'tumour necrosis factor-alpha inhibitor', 'biologic therapy', 'biologic treatment', 'adalimumab', 'etanercept', 'infliximab,' 'ustekinumab' and 'rituximab'.
The use of etanercept in classic febrile neutrophilic dermatosis is not well documented and has been recorded only three times.
Under the terms of the agreement, Mylan will commercialise Lupin's proposed etanercept biosimilar in Europe, Australia, New Zealand, Latin America, Africa and most markets throughout Asia.
A recent study evaluating the biosimilar in comparison with its reference drug found that etanercept had stable clinical efficacy and a comparable safety profile and was well tolerated.
In August 2015, due to persistent clinical activity with increased acute-phase reactant levels (C-reactive protein level of 16mg/l), the treatment with etanercept at 25 mg twice weekly was started.
As published, Figure 3(b) from our scientific article "New Alternatives for Autoimmune Disease Treatments: Physicochemical and Clinical Comparability of Biosimilar Etanercept" contains different glycan profiles of Enbrel [2].
In the present study, we aimed to evaluate treatment with different concentrations of etanercept on cell growth and cell apoptosis in a rat model of cardiomyocyte hypertrophy l.
(7) On the other hand, infliximab, an anti-TNF-[alpha] monoclonal antibody, has been shown to be effective in the treatment of pulmonary sarcoidosis while etanercept, a soluble TNF-[alpha] receptor fusion protein, has not.