What is etanercept and why is it prescribed?
Etanercept (trade name: Enbrel) is a type of drug known as anti-TNF. In rheumatoid arthritis and some other inflammatory conditions, too much of a protein called TNF (tumour necrosis factor) is produced in the body, causing inflammation, pain and damage to the bones and joints. Anti-TNF drugs such as etanercept block the action of TNF and so reduce this inflammation.
Etanercept isn't a painkiller, but can modify the disease and should start to improve your symptoms over a period of 2–12 weeks.
Etanercept can be prescribed by a consultant rheumatologist for:
There are national and local guidelines that determine when it can be prescribed, and these vary according to which condition you have. It's usually given along with other disease-modifying drugs – for example, methotrexate or sulfasalazine.
Before starting etanercept you'll have a chest x-ray and tests to check if you've ever been exposed to tuberculosis (TB). You may need treatment for latent (asymptomatic) TB before starting etanercept. You'll also be checked for previous hepatitis infection, as etanercept may increase the risk of hepatitis being reactivated.
You may have further blood tests while you're on etanercept to monitor its effects.
Are there any reasons I won't be prescribed etanercept?
Etanercept won't be started if:
- your arthritis isn't active
- you have an infection
- you haven't tried other treatments appropriate for your condition first.
Doctors sometimes use a score known as DAS28 to work out how active your arthritis is. This counts how many of 28 specific joints are tender and swollen, and looks at inflammation levels in a blood test. You'll also be asked to score how well you feel on a scale of 0 to 10.
Your doctor may decide not to prescribe etanercept if you've had:
- repeated or serious infections
- multiple sclerosis (MS)
- a serious heart condition
- lung fibrosis (scarring of the lung tissue).