Etanercept is given as a shot under the skin (subcutaneous
How It Works
Etanercept reduces the effects of tumor
necrosis factor (TNF). TNF is a protein that attaches to the joint surface and
inflammation and joint damage. Etanercept blocks the
action of TNF and reduces symptoms and slows the progression of
Etanercept is a
disease-modifying antirheumatic drug (DMARD), which means it slows the
progression of the disease. DMARDs are also called immunosuppressive drugs or
slow-acting antirheumatic drugs (SAARDs).
Why It Is Used
Etanercept is used to treat severe
rheumatoid arthritis when other medicines have not been effective. It also
may be used in combination with methotrexate.
How Well It Works
Etanercept works quickly with
minimal side effects. It appears to affect disease activity within weeks. When
used alone or in combination with methotrexate, it decreases pain and swelling
better than methotrexate alone.1 Combining etanercept
with methotrexate has produced good results, greatly slowing damage to joints
while increasing functional ability.2
Etanercept is effective in relieving joint pain and swelling in
rheumatoid arthritis that has not improved with methotrexate or other
The most common side effect of TNF
antagonists such as etanercept is an allergic reaction to the injection (shot).
If you have a reaction to the shot, it will happen right away, either during
the shot or within 1 to 2 hours after the shot. Your doctor may give you
medicines to prevent or stop the reaction.
Symptoms of a reaction
to the shot include:
- Shortness of breath.
- Heat and
redness (flushing) in the
Warnings about serious side effects of TNF antagonists have
been issued. The U.S. Food and Drug Administration (FDA) and the drug’s
manufacturers have warned about:
- An increased risk of a serious infection. TNF antagonists affect
your body's ability to fight all infections. So if you get a fever, cold, or
the flu while you are taking this medicine, let your doctor know right
- An increased risk of blood or nervous system disorders. Call
your doctor if you have symptoms of blood disorders (such as bruising or
bleeding) or symptoms of nervous system problems (such as numbness, weakness,
tingling, or vision problems).
- A possible increased risk of
lymphoma (a type of blood cancer). It is not clear
whether this increase is because of the drug or because people with this
disease may already have a higher risk. There have been reports of a rare kind
of lymphoma, occurring mostly in children and teens taking TNF antagonists,
that often results in death.
- An increased risk of liver injuries.
Call your doctor if your skin starts to look yellow, if you are very tired, or
if you have a fever or dark brown urine.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
Etanercept is expensive; it may
cost significantly more than other DMARDs.1
Etanercept should not be used by pregnant women or women of childbearing
age who are not using reliable birth control. If you are going to take
etanercept, you should be on some form of reliable birth control. If you plan
to become pregnant, check with your health professional before stopping birth
control and trying to become pregnant.
Etanercept is a relatively
new medicine. Its long-term safety and effectiveness are not fully
Etanercept can be
self-administered once you receive training and instructions from your health
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Blumenauer B, et al. (2003). Etanercept for the
treatment of rheumatoid arthritis. Cochrane Database of Systematic Reviews (3).
Klareskog L, et al. (2004). Therapeutic effect of the
combination of etanercept and methotrexate compared with each treatment alone
in patients with rheumatoid arthritis: Double-blind randomised controlled trial.
Lancet, 363(9410): 675-681.
Drugs for rheumatoid arthritis (2009). Treatment Guidelines From The Medical Letter, 7(81): 37-46.
Walker-Bone K, Fallow S (2007). Rheumatoid arthritis,
search date June 2005. Online version of BMJ Clinical Evidence. Also available online: