Etanercept for ankylosing spondylitis

Examples

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Brand Name	Generic Name
Enbrel	etanercept

Etanercept is given as an injection under the skin.

How It Works

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Etanercept is a man-made protein that blocks the action of tumor necrosis factor (TNF). TNF is a protein produced by your body that causes inflammation.

Why It Is Used

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Doctors may use etanercept to treat pain and increase mobility in people with active ankylosing spondylitis when other medicines have not been effective. It is also used to effectively treat symptoms of rheumatoid arthritis.

How Well It Works

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Treatment with etanercept over a few months can result in significant and continued improvement of symptoms from ankylosing spondylitis.¹

Side Effects

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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:

• Fever.
• Chills.
• Chest pain.
• Shortness of breath.
• Itching (pruritus).
• Headache.
• Nausea.
• Heat and redness (flushing) in the face.
• Rash.
• Fatigue.
• Dizziness.

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 away.
• 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

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Etanercept suppresses the immune system, making it difficult for the body to fight infection. This means you cannot take etanercept if you have an active viral or bacterial infection, including untreated tuberculosis, nor within 3 months of a live-virus vaccine.

Pregnant women or women of childbearing age who are not using reliable birth control should not use etanercept. If you are going to take etanercept, you should be on some form of reliable birth control. You also should not use etanercept if you are breast-feeding.

People with heart failure or with a demyelinating nerve disease such as multiple sclerosis should not use etanercept.

Etanercept is a relatively new medicine. Its long-term safety and effectiveness are not fully known.

Etanercept can be self-administered once you receive training and instructions from your health professional.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Gorman JD, et al. (2002). Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor a. New England Journal of Medicine, 346(18): 1349–1356.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Tracy Landauer
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	May 18, 2007