Etanercept (Enbrel)

This is a fusion protein. This is a TNF-alpha receptor fused onto human IgG. It acts by inhibiting TNF-alpha activity.

It is used for rheumatoid arthritis,juvenile rheumatoid arthritis as well as psoriatic arthritis. This shows good activity against psoriatic arthritis with eighty-seven percent of patients in one study showing significant improvement compared to twenty-three percent in the placebo group. In patients with skin psoriasis about one quarter showed seventy-five percent improvement in their PASI scores.

Dosage

Etanercept is given as a 25 mg twice weekly dose injected subcutaneously at home. This drug should be avoided in patients with a history of multiple sclerosis.

Side Effects

The common side effect is at the site of injection. These reactions are usually mild to moderate and diminish in frequency after the first month of treatment. Redness, itching, pain and swelling were described. There is a slight increase in the incidence of upper respiratory tract infections. It should not be used in those with congestive heart disease. There is a risk of re-activating tuberculosis so therefore it is avoided in individuals with positive tuberculin skin tests. There is a small series of patients who have developed signs of drug induced systemic lupus. It is possible that this drug may unmask multiple sclerosis.

Drug Interactions

This drug has been used in combination with both cyclosporine and methotrexate.

(GCS) GotClearSkin.com

Biologic Drugs and How They Work

We are entering a very exciting stage in medical treatment in that drugs have been designed to specifically hit immunological targets that are involved in specific conditions. Previous immune therapy has involved drugs that have a general suppressing effect on the immune system which consequently prevents high doses being used because of the fear of side effects. Theoretically the more specific the target to be blocked, the less interference with other biological functions - making the drug safer.

These new drugs are known as biological drugs. They are created in living cells. The technique has been used for a long time for drugs such as insulin or interferon.

There are a number of new biologic drugs that are currently used in psoriasis.

Alefacept (Amevive)
Efalizumab (Raptiva)
Inflixiamab (Remicaide)
Etanercept (Enbrel)
Explanation of the difficult drug names:

The suffix denotes the drug class.

Mab = monoclonal antibody

Ximab = chimeric(mouse-human) monoclonal antibody

Zumab = Humanized monoclonal antibody-ie. Reducing the amount of mouse to under10%

Umab = Human monoclonal antibody

Cept = receptof –antibody fusion protein that mimics an immunoglobulin

These drugs can target different steps in the pathway of producing psoriasis. The following general targets have been identified and can be blocked.

T-cell activation
Inhibiting memory or activated T-cells
Blocking the migration of T-cells into the skin
Inhibiting the chemicals or cytokines produced eg. tumor necrosis factor
Blocking conversion of one cytokine into another

(GCS) GotClearSkin.com

New Innovative Delivery System For Enbrel

Wyeth Launches New Innovative Delivery System For Enbrel
Main Category: Arthritis / Rheumatology Also Included In: Eczema / Psoriasis Article Date: 13 Sep 2009 Enbrel , Wyeth's biological treatment for rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and psoriasis, is now available as a new easy-to-use pre-filled auto-injector device, known as the Enbrel MYCLIC pen.

Read full story from MediLexicon

http://www.medilexicon.com/medicalnews.php?newsid=163742