Etanercept for ankylosing spondylitis

Examples

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Brand Name	Chemical 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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Common:

• Irritation at the site of the injection
• Temporary symptoms for 1 to 2 days after the injection, including:
  • Mild runny nose, dry cough
  • Low-grade fever
  • Body aches
  • Fatigue

Uncommon:

• Bacterial infection (such as urinary tract infection, strep throat, bronchitis, or pneumonia) requiring oral antibiotics
• Temporary return of an old viral infection, such as:
  • Shingles (herpes zoster)
  • Cold sores (herpes simplex)

Rare:

• Severe bacterial infection requiring a stay in the hospital for treatment
• Return of tuberculosis that has been dormant or in remission
• Return of symptoms of a demyelinating disease such as multiple sclerosis that has been in remission
• Possible increased risk of lymphoma

Risk of infection

Etanercept decreases the activity of your body's immune system, which increases the risk of a serious bacterial infection. Some people who take etanercept develop an infection that requires oral antibiotics; a smaller number of people will develop an infection that requires intravenous antibiotics and hospitalization. Contact your doctor if you develop any of the following symptoms:

• Fever or chills
• Increased frequency or burning of urination
• A cough with yellow sputum or shortness of breath
• A skin infection
• Severe abdominal pain or diarrhea
• A severe sore throat
• Sinus pain with yellow mucus
• A painful, burning rash in a band across one side of your body (shingles)
• Painful, widespread mouth sores

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
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	May 18, 2007