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Enbrel vs Humira

Drug facts and comparison

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Medically reviewed by  Jamie Winn, PharmD

Uses

  • Moderate to severe chronic plaque psoriasis
  • Psoriatic arthritis with or without methotrexate
  • Moderate to severe rheumatoid arthritis with or without methotrexate
  • Ankylosing spondylitis (inflammation of joints in the spine).
  • Moderate to severe polyarticular juvenile idiopathic arthritis (joint pain and inflammation in children and adolescents with more than 4 joints affected)
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  • Moderate to severe active rheumatoid arthritis in adults
  • Moderate to severe active polyarticular (affecting multiple joints) juvenile idiopathic arthritis in children aged two years and older
  • Moderate to severe chronic plaque psoriasis in adults
  • Active psoriatic arthritis in adults
  • Active ankylosing spondylitis in adults
  • Moderate to severe active ulcerative colitis in adults
  • Moderate to severely active Crohn’s Disease in adults and children aged six years and older
  • Moderate to severe hidradenitis suppurativa (HS) in adults and children aged 12 years and older
  • Uveitis in adults and children aged two years and older
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Summary

Brand name: Enbrel
Brand name: Humira
Manufacturer: Amgen
Manufacturer: Abbvie Inc.
Active ingredient: etanercept
Active ingredient: adalimumab
Indication: Moderate to severe chronic plaque psoriasis Psoriatic arthritis with or without methotrexate Moderate to severe rheumatoid arthritis with or without methotrexate Ankylosing spondylitis (inflammation of joints in the spine). Moderate to severe polyarticular juvenile idiopathic arthritis (joint pain and inflammation in children and adolescents with more than 4 joints affected)
Indication: Moderate to severe active rheumatoid arthritis in adults Moderate to severe active polyarticular (affecting multiple joints) juvenile idiopathic arthritis in children aged two years and older Moderate to severe chronic plaque psoriasis in adults Active psoriatic arthritis in adults Active ankylosing spondylitis in adults Moderate to severe active ulcerative colitis in adults Moderate to severely active Crohn’s Disease in adults and children aged six years and older Moderate to severe hidradenitis suppurativa (HS) in adults and children aged 12 years and older Uveitis in adults and children aged two years and older
Frequency of injection: Once or twice weekly
Frequency of injection: Once every 2 weeks
Duration of action: Once or twice weekly
Duration of action: Once every 2 weeks
Injection method: Subcutaneous injection
Injection method: Subcutaneous injection

Side Effects

Most common

  • Injection sire reactions
  • Increased rate of sinus, bronchitis, urinary tract, and skin infections
  • Headache

More serious

  • Serious infections
  • Suppression of the immune system
  • Increased risk of cancer, particularly lymphoma
  • New or worsening heart failure
  • Inflammation of the blood vessels
  • New or worsening psoriasis
  • Allergic reactions

Most common

  • Injection site reactions
  • Headaches
  • Skin rashes
  • Nausea
  • Vomiting
  • Abdominal pain
  • Musculoskeletal pain (pain in bones, joints, and nerves)
  • Upper respiratory infections, including sinus infections

More serious

  • Serious allergic reactions to the medication
  • Serious infections, including tuberculosis and sepsis
  • Activation of a hepatitis B infection in people who carry the hepatitis B virus
  • Heart failure or worsening heart failure
  • Liver problems and liver failure

Drug Interactions

Severe interactions
  • Immunomodulators – abatacept
  • Corticosteroids – betamethasone, cortisone, dexamethasone
  • Antisphychotics – clozapine
  • Immunosuppressants – fingolimod, ozanimod, siponimod
  • DMARDs – leflunomide, teriflunomide
Serious interactions
  • Statins – atorvastatin, pravastatin, simvastatin
  • Anticonvulsants – carbamazepine, phenobarbital, phenytoin
  • Benzodiazepines – clonazepam, diazepam, triazolam
  • Calcium channel blockers – amlodipine, felodipine, nifedipine
  • Opioids – hydrocodone, oxycodone
Moderate interactions
  • Zinc preparations – zinc acetate, zinc chloride, zinc gluconate, zinc sulfate
Severe interactions
  • Immunomodulators – abatacept
  • Corticosteroids – betamethasone, cortisone, dexamethasone
  • Antisphychotics – clozapine
  • Immunosuppressants – fingolimod, ozanimod, siponimod
  • DMARDs – leflunomide, teriflunomide
Serious interactions
  • Statins – atorvastatin, pravastatin, simvastatin
  • Anticonvulsants – carbamazepine, phenobarbital, phenytoin
  • Benzodiazepines – clonazepam, diazepam, triazolam
  • Calcium channel blockers – amlodipine, felodipine, nifedipine
  • Opioids – hydrocodone, oxycodone
Moderate interactions
  • Zinc preparations – zinc acetate, zinc chloride, zinc gluconate, zinc sulfate

Warnings

You should not use Enbrel if you:

  • Are allergic to the active ingredient etanercept
  • Are allergic to any of the other ingredients in Enbrel
  • Are at risk of developing a serious blood infection called sepsis
  • If you have any kind of infection

You should talk to your doctor before using Enbrel if you:

  • Have a history of recurring infections
  • Have a history of congestive heart failure
  • Have ever had cancer
  • Have diabetes
  • Have ever had tuberculosis, or have been in close contact with someone who has had tuberculosis
  • Have ever had Hepatitis B or Hepatitis C
  • Have multiple sclerosis
  • Have optic neuritis (inflammation of the nerves in the eyes)
  • Have transverse myelitis (inflammation of the spinal cord)
  • Are allergic to latex (the needle cap of the injecting pen is made from latex)
  • Are under 18 years of age (Enbrel is suitable for children, but varying age limits are recommended for different autoimmune diseases)

You should not use Humira if you:

  • Are allergic to the active ingredient adalimumab
  • Are allergic to any of the other ingredients found in Humira
  • Have active tuberculosis or another severe infection
  • Have moderate or severe heart failure
  • Are taking a medication with the active ingredients anakinra or abatacept
  • Are pregnant, but you may be able to breastfeed whilst taking it

You should talk to your doctor before using Humira if you:

  • Are over 65, as Humira can make it more likely you will get infections
  • Have an infection, or a condition that makes it easier for you to get infections
  • Have infections that keep coming back
  • Have ever had tuberculosis, or if you’ve been in close contact with someone with tuberculosis
  • Have or have had cancer
  • Have traveled to regions where fungal infections are common
  • Have had mild heart failure, or another serious heart condition
  • Have a demyelinating disease, like multiple sclerosis
  • Have the hepatitis B virus (HBV)
  • Are about to have surgery or a dental procedure
  • Are about to have a vaccination

Dosage

Once or twice weekly.

10 mg, 20 mg, or 40 mg every other week.

Cost

Enbrel subcutaneous solution (50 mg/mL) will cost around $6,700 for 4 milliliters.

 

Humira subcutaneous kit (40 mg/0.8 mL) will cost around $6,700 for 2 kits.

 

FAQs

The American College of Rheumatology treatment guidelines recommends biologic drugs such as Enbrel (etanercept), Humira (adalimumab), Cimzia (certolizumab pegol), Simponi (golimumab), and Remicade (infliximab) as a treatment option after methotrexate for people with autoimmune conditions such as rheumatoid arthritis. These drugs are also classed as disease-modifying antirheumatic drugs (DMARDs), which means they can treat the underlying cause of your condition and reduce inflammation. DMARDs can improve symptoms such as joint damage, pain, and swelling.

Today, we’ll focus on two of the options available: Enbrel vs Humira. Although they fall into the same class of drugs, share certain features and both have shown to be effective in clinical trials, they also have differences. Let’s get to know these medications and then you can decide which one is right for you.

What is Enbrel?

Enbrel is the brand name of a medication manufactured by Amgen containing the active ingredient etanercept. It is approved by the US Food & Drug Administration (FDA) to treat the following autoimmune diseases:

  • Moderate to severe chronic plaque psoriasis
  • Psoriatic arthritis with or without methotrexate
  • Moderate to severe rheumatoid arthritis with or without methotrexate
  • Ankylosing spondylitis (inflammation of joints in the spine).
  • Moderate to severe polyarticular juvenile idiopathic arthritis (joint pain and inflammation in children and adolescents with more than 4 joints affected)

What is Humira?

Humira is an FDA-approved medication manufactured by Abbie Inc. containing the active ingredient adalimumab.

Humira is approved by the FDA to treat the following inflammatory autoimmune diseases:

  • Moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy
  • Active psoriatic arthritis in adults
  • Rheumatoid arthritis in adults
  • Ankylosing spondylitis in adults
  • Ulcerative colitis in adults
  • Juvenile idiopathic arthritis in children aged 2 years and older

Humira is also approved to treat similar non-autoimmune inflammatory diseases:

  • Crohn’s Disease in adults and children aged 6 years and older
  • Hidradenitis suppurativa (HS) in adults and children aged 12 years and older
  • Uveitis in adults and children aged two years and older

Do Enbrel and Humira work in the same way?

Yes. Once Enbrel or Humira is injected into your body, the active ingredients in the drugs which are known as tumor necrosis factor (TNF) inhibitors or TNF blockers start working to help reduce inflammation. Your immune system triggers inflammation by releasing a signaling molecule called TNF-alpha (an antibody). This molecule attaches itself to areas inside your cells, beginning the process that causes inflammation. The active ingredients in Enbrel and Humira stop this from happening. They attach themselves to TNF-alpha molecules, stopping them from working. This limits the amount of inflammation your immune system can cause.

How do you take Enbrel and Humira?

You are given Enbrel and Humira by subcutaneous injection (injecting it under your skin) using either a pre-filled syringe or an injectable pen. It is important to use a new needle each time to prevent the risk of infection. You may get injection site reactions such as redness, bruising, or irritation after administration, but this will settle down after a few hours.

What are the side effects of Enbrel and Humira?

As Enbrel and Humira belong to the same drug class their side effects are similar.

Common side effects include:

  • Injection site reactions
  • Sinus infection
  • Headache

Serious side effects include:

  • Suppression of the immune system
  • Increased risk of cancer, particularly lymphoma
  • New or worsening heart failure
  • New or worsening psoriasis
  • Allergic reactions
  • Serious infections

What about other medications?

Some people take Enbrel or Humira alone, and others take them in combination with methotrexate.

Enbrel and Humira have drug interactions with the following drugs

If you have a hepatitis B virus infection, taking Enbrel or Humira could activate your infection. Your doctor will test your blood to make sure you don’t have hepatitis B before you receive either of these drugs.

Other medical conditions may affect your treatment with Enbrel or Humira so you should always seek medical advice from the healthcare professional prescribing your drugs.

What are autoimmune diseases?

Your immune system kills and removes harmful pathogens that can make you ill and help you recover from injuries. However, sometimes your immune system can mistakenly attack healthy parts of your body, causing an autoimmune disease. Many of these autoimmune diseases cause inflammation.

Inflammation is a vital part of your immune system’s response to infection. It signals to your body to defend itself and that repair is needed. However, inflammation in healthy tissue, especially if it persists, can cause damage. Rheumatoid arthritis is caused by chronic inflammation in your joints, whilst ankylosing spondylitis is caused by chronic inflammation in your spine.

Are biosimilars available for Enbrel and Humira?

Biosimilar alternatives to both Enbrel and Humira exist. Erelzi is a biosimilar to Enbrel available in the US. Humira biosimilars are not yet available for use in the United States.

Does Enbrel cause weight gain?

No, it is unlikely Enbrel will cause weight gain. Weight gain was not seen as a side effect in clinical trials. On the other hand, if you have unexplained weight loss, it could be a sign of a serious infection caused by Enbrel e.g hepatitis B and tuberculosis. Speak to your doctor right away if you experience any changes in weight.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.
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