About Psoriatic Arthritis
Once diagnosed, psoriatic arthritis is a lifelong disease of the immune system. It is associated with pain, stiffness, or swelling in joints and generally with raised red patches, often with a silvery scale (psoriatic skin lesions). If you have psoriatic arthritis, you are not alone; it is estimated that about 1 million Americans have this disease. Psoriatic arthritis may appear at any time, but most often develops between the ages of 30 and 55. If you think you have psoriatic arthritis, it's a good idea to see a doctor right away; especially if left untreated, people with psoriatic arthritis are at risk of permanent joint damage.
Psoriatic arthritis is a disease of the immune system
In people with psoriatic arthritis, certain immune cells are activated and produce too much of a protein called tumor necrosis factor (TNF). This protein is one of the causes of inflammation in the skin, which can cause skin cells to grow too quickly. The skin cells build up and form raised, red patches, often with silvery scales, known as psoriatic lesions. This protein also causes inflammation in the joints, which can create pain and progressive joint damage.
- Swelling of an entire finger or toe
- General joint pain and stiffness
- Swelling in the joints
- Back pain and stiffness (lower back, neck, and upper back)
- Raised, red patches, often with a silvery scale (known as psoriatic skin lesions)
- Changes in the nails: pitting is seen in the fingernails and toenails of 90% of psoriatic arthritis patients
Psoriatic arthritis symptoms can change in severity and vary from person to person. Psoriatic arthritis can affect many joints in the body and can affect different areas of the body in the same person over time. The skin symptoms of psoriatic arthritis often appear before joint symptoms. In approximately 70% of psoriatic arthritis patients, skin symptoms appear before joint symptoms; in some cases, skin symptoms may be present for up to 10 years or more before joint symptoms like pain and swelling appear. Psoriatic arthritis can lead to permanent joint damage, but some treatments can help stop joint damage from progressing.
How can psoriatic arthritis be treated?
The symptoms of psoriatic arthritis may be treated with a number of different medicines. ENBREL is a type of medicine called a biologic that treats both skin and joint symptoms. ENBREL works on the immune system to help slow the growth of excess skin cells and to reduce joint pain and inflammation. Learn how ENBREL works in two different psoriatic conditions, adult chronic moderate to severe plaque psoriasis (in patients who are candidates for systemic therapy or phototherapy) and psoriatic arthritis.
Because ENBREL works on your immune system, it may lower your ability to fight infections and may raise other safety concerns. If you have any sign of an infection including a fever, cough, or flu-like symptoms or have any open sores on your body, call your doctor.
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We can answer any general questions you may have about ENBREL and help with more specific inquiries, including financial assistance, injection tips, and dosing information.
Prescription ENBREL is taken by injection.
Please scroll to read Important Safety Information and Indications.
IMPORTANT SAFETY INFORMATION AND INDICATIONS
What is the most important information I should know about Enbrel® (etanercept)?
ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your doctor should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.
There have been some cases of unusual cancers reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA or psoriasis may be more likely to get lymphoma.
Before starting ENBREL, tell your doctor if you:
- Have any existing medical conditions
- Are taking any medicines, including herbals
- Think you have, are being treated for, have signs of, or are prone to infection. You should not start taking ENBREL if you have any kind of infection, unless your doctor says it is okay
- Have any open cuts or sores
- Have diabetes, HIV, or a weak immune system
- Have TB or have been in close contact with someone who has had TB
- Were born in, lived in, or traveled to countries where there is more risk for getting TB. Ask your doctor if you are not sure
- Live, have lived in, or traveled to certain parts of the country (such as, the Ohio and Mississippi River valleys, or the Southwest) where there is a greater risk for certain kinds of fungal infections, such as histoplasmosis. These infections may develop or become more severe if you take ENBREL. If you don't know if these infections are common in the areas you've been to, ask your doctor
- Have or have had hepatitis B
- Have or have had heart failure
- Develop symptoms such as persistent fever, bruising, bleeding, or paleness while taking ENBREL
- Use the medicine Kineret® (anakinra), Orencia® (abatacept), or Cytoxan® (cyclophosphamide)
- Are taking anti-diabetic medicines
- Have, have had, or develop a serious nervous disorder, seizures, any numbness or tingling, or a disease that affects your nervous system such as multiple sclerosis or Guillain-Barré syndrome
- Are scheduled to have surgery
- Have recently received or are scheduled for any vaccines. All vaccines should be brought up-to-date before starting ENBREL. Patients taking ENBREL should not receive live vaccines.
- Are allergic to rubber or latex
- Are pregnant, planning to become pregnant, or breastfeeding
- Have been around someone with chicken pox
What are the possible side effects of ENBREL?
ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.
Common side effects include: Injection site reactions, upper respiratory infections (sinus infections), and headache.
In a medical study of patients with JIA, side effects were generally similar in frequency and type as those seen in adult patients. The kinds of infections reported were generally mild and similar to those usually seen in children.
These are not all the side effects with ENBREL. Tell your doctor about any side effect that bothers you or does not go away.
If you have any questions about this information, be sure to discuss them with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Moderate to Severe Rheumatoid Arthritis (RA)
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.
Moderately to Severely Active Polyarticular Juvenile Idiopathic Arthritis (JIA)
ENBREL is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older.
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.
Ankylosing Spondylitis (AS)
ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.
Adult Chronic Moderate to Severe Plaque Psoriasis
ENBREL is indicated for the treatment of adult patients (18 years or older) with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.