How long does it take for Enbrel to work? (+3 tips)

In this article, we will discuss how long it takes for Enbrel to work. Enbrel (etanercept) is approved for the treatment of rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, and ankylosing spondylitis.

How long does it take for Enbrel to work?

Enbrel may take 2-12 weeks to work, depending on the disease condition. Most people find relief in arthritic symptoms within three months, however, it may take six months for optimum effect. Be sure to have regular follow-ups with your doctor to see the progress of Enbrel (1).

Although Enbrel takes some time to show its effect, data suggest that 73-85% of patients with early rheumatoid arthritis and 53-72% of patients with longstanding rheumatoid arthritis achieved a clinically significant improvement in their symptoms (2).

Chronic inflammatory diseases, such as rheumatoid arthritis and psoriases, can take up to several weeks to get better. Therefore, you may require consistent use of Enbrel. If you feel that there is no improvement in your symptoms, talk to your doctor.

How to know if Enbrel is working?

The following improvement in arthritis and psoriasis symptoms shows that Enbrel has started working:

• Reduced pain,
• Reduced swelling,
• Reduced stiffness,
• Skin clears up in case of psoriasis,
• Reduced flare-up and remission,
• Less fatigue, and
• Improved appetite.

Factors affecting the time taken by Enbrel to work

Several factors may affect the time taken by Enbrel to work properly. Some of these factors are patient-related (such as noncompliance) whereas others are dose-related (such as side effects and contradictions).

Noncompliance

Some patients may show noncompliance with the dosage regimen as Enbrel takes 2-12 weeks (or months) to exert its effect. Also, the pain at the injection site, side effects, or possible allergic reactions reduce the patient’s interest in taking Enbrel. 

Side effects

Enbrel is a biological drug that is known to reduce tumour necrosis factor (TNF), hence reducing inflammation. Because it affects the immune system, you may feel sick because of other infections including tuberculosis and bacterial sepsis (3).

If you get these severe infections, it may compromise your health and quality of life. Your doctor may prescribe another drug if your health deteriorates rapidly. Some other side effects include non-upper respiratory infections, rhinitis, and headache.

Severity of disease

The severity of the disease plays an important role in determining the effectiveness of Enbrel. If your symptoms are mild, Enbrel may start working early. However, if your symptoms are worse, it may take more time for Enbrel to give you complete relief. 

Pregnancy

Enbrel has not been fully studied in pregnant women. You should inform your doctor if you are pregnant, planning to get pregnant, or breastfeeding. You may continue taking Enbrel for six months. After that, your doctor may switch your therapy to another safer drug (4).

What to do if Enbrel fails to manage your symptoms effectively?

Consult your doctor if Enbrel fails to manage your symptoms effectively. The lack of effectiveness may be due to several factors such as the severity of disease or failure to follow the dosage regimen. Some other factors include:

• Sometimes the lack of effectiveness may be due to an incorrect dose. Enbrel is usually prescribed once a week. However, plaque psoriasis requires two doses/week for 3 months.
• Follow your doctor’s instructions for proper dosing and administration of Enbrel injection. If you are not trained to administer it yourself, go to a hospital or pharmacy.
• Do not miss a dose of Enbrel. You may want to set an alarm or mark it on a calendar. If you miss a dose, consult your doctor before taking the missed dose.
• Always inform your doctor about the medicines you take apart from Enbrel, including prescription and nonprescription drugs, supplements, and herbal medicine.
• Your doctor may prescribe you another medicine if Enbrel fails to work for you. Some alternatives to Enbrel include 

Alternatives to Enbrel if it fails to manage symptoms effectively

If you feel that your symptoms are not improving or side effects are worsening after taking Enbrel, you may discuss these conditions with your doctor. Your doctor may prescribe you another drug.

Other TNF blockers

If you have rheumatoid arthritis, your doctor may prescribe you another TNF inhibitor, including adalimumab and infliximab. They belong to the same class of drugs and work by blocking immune system proteins that cause arthritic symptoms.

Disease-modifying-antirheumatic drug (DMARD)

Methotrexate is a DMARD that is used to reduce the activity of the immune system in rheumatoid arthritis. Methotrexate should be used with caution as it may induce some serious, life-threatening side effects.

Janus kinase inhibitor (JAKi)

Alternatively, your doctor may prescribe baricitinib, ruxolitinib, and inrebic which is a Janus kinase inhibitor. It is often prescribed for severely active rheumatoid arthritis, especially if TNF blockers have failed to exert their effect in reducing the symptoms (5).

T-cell costimulatory modulator

T-cell costimulatory modulators such as Orencia are used to suppress T-cell proliferation and B-cell stimulation by binding to the CD80 and CD86 receptors. It is recommended for patients who do not respond well to Enbrel, methotrexate, or other TNF inhibitors (6).

As a pharmacist, I would advise you to stick to the dosage regimen prescribed by your doctor and give Enbrel some time to show its effect. If you have extreme pain, depression, and mood swings, your doctor may prescribe Cymbalta (antidepressant) as an adjunct therapy.

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