Enbrel is approved by Health Canada for adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy. It is also approved for psoriatic arthritis.
How Does It Work?
Enbrel is an approved receptor protein blocker that neutralizes a messenger protein called TNF (tumour necrosis factor) which is involved in the development of psoriasis. By blocking the effect of TNF, Enbrel prevents the body’s autoimmune attack against the skin of those suffering from psoriasis and psoriatic arthritis.
How Is it Administered?
Enbrel is given as an injection under the skin. It is given as 50mg twice weekly for the first 3 months then once a week continuously .
A pre-filled syringe as well an auto-injector is available for ease of use.
What are its Side Effects?
Since it is a biologic treatment that suppresses your immune system, patients taking it have a higher chance of catching an infection. Prior to starting treatment with Enbrel, your doctor will evaluate you for a tuberculosis infection. Those who have a current TB infection cannot start Enbrel. Also patients with congestive heart failure or a personal of family history of demyelinating diseases such as multiple sclerosis must also NOT be give Enbrel. Caution is warranted in patients with active serious infections or a history of recurrent infections.
The most frequently reported adverse reaction were mild-moderate upper respiratory infections (e.g.: a runny nose or sore throat).
Special Populations and Enbrel
- Pregnant Women: there are no adequate clinical trials on the use of Enbrel during pregnancy, however animal studies did not show any harmful effects in pregnancy. The current recommendation is use Enbrel during pregnancy only if the benefit justifies the potential risk to the fetus.
- Nursing women: It is not known whether Enbrel is excreted in human milk, so caution should be exercised when taking it while nursing.
- Fertility: The effects on human fertility have not been evaluated. However, animal studies did not indicate any harmful effects on fertility.
- Children < 18 years old: The safety and efficacy of Enbrel in paediatric patients have not been studied yet, so for this patient population, Enbrel is not recommended.
- Elderly patients >65 years old: Limited studies suggest that there is no difference in safety and efficacy between older and younger patients.
- Kidney/Liver Impairment: Enbrel has not been studied in these patient populations.
What medications should I pay attention to when on Enbrel?
- Enbrel suppresses your immune system’s response to infection, which prevents it from releasing your body’s “fighter cells” that help you build an immunity to components of vaccines. For this reason, patients on Enbrel (and other biologic medications) cannot have any live vaccine given to them. Some examples are: Influenza nasal vaccine, MMR, Rotavirus, Smallpox, Varicella/Zoster, Yellow Fever, Thyphoid.
- You can and should, however, receive inactivated or non-live vaccinations, such as the yearly influenza vaccine (injectable) and the meningococcal vaccine. Data suggest that Enbrel does not suppress your immune system’s response to either of these vaccines.
For detailed information on side effects, safety and if this medication is right for you, please speak to your doctor.