Remicade is a monoclonal antibody against TNF. It is usually given by IV infusion together with methotrexate. It is given as a self injection usually every week. Keep reading to find out. Note: For more information about these drugs, see these in-depth Enbrel and Remicade articles. Enbrel contains etanercept as its active ingredient. Remicade contains infliximab as its active ingredient. TNF is linked to inflammation.
By blocking TNF, these medications can help reduce inflammation and ease symptoms. Enbrel and Remicade are prescription medications used to treat certain autoimmune diseases.
Remicade is also used to treat the following types of inflammatory bowel disease in adults and children ages 6 years and older:. Note: For more details about the use of these medications, see these in-depth Enbrel and Remicade articles. Enbrel comes in several forms, while Remicade comes in only one form.
Enbrel is given as an injection under your skin, usually once or twice every week. If Enbrel becomes part of your treatment plan, your healthcare provider will teach you how to use it.
Then you can give yourself Enbrel at home. Remicade is given as an infusion, usually once every 4 to 8 weeks. With an infusion, medication is dripped into your vein over a period of time. A Remicade infusion takes about 2 hours. Remicade is available in just one form: a vial of powder. A healthcare provider will mix the powder with sterile water as part of the preparation for your infusion. For both Enbrel and Remicade, your dosage will depend on your condition.
Talk with your doctor to discuss the dosage that may work best for your treatment plan. To see estimates of what Enbrel and Remicade may cost, visit GoodRx. Enbrel and Remicade are both biologic medications. A biologic is made from parts of living organisms. Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs. Enbrel and Remicade are both meant to be long-term treatments.
This experience has revealed that not all of them are effective in every condition. Conversely, in clinical trials for severe heart failure, infliximab aggravated the condition whilst etanercept did not [ 16 , 17 ].
The reasons underlying these differences are unknown. However, there are a number of possible explanations. The high drug concentrations arising only from the intravenous bolus of infliximab may be important in Crohn's disease.
It is also possible that these agents possess different capacities to penetrate into the gut wall. However, there are no published data addressing this. Either way, these fundamental differences in efficacy beg for further work, using these agents as tools to provide crucial insights into the basic pathological mechanisms. All are associated, as expected, with an increase in infection, which may be serious [ 18 ].
However, patients taking infliximab appear to have a higher risk of infection from histoplasmosis, coccidiomycosis or reactivation of tuberculosis TB [ 19 , 20 ], although this is contended [ 21 ].
Cases of TB were also reported in the early studies of adalimumab, particularly at doses higher than those that were subsequently licensed, suggesting a dose—response effect. The potential risk of reactivation of mycobacterial infections is a particular cause of concern in developing countries, where there is a much higher burden of chronic infection. The choice of biological treatment for RA may depend pragmatically on a number of factors, including patient preference, the tolerability of methotrexate and day-case infusion facilities.
Since a direct head-to-head comparison is not likely, it is difficult to determine if one biological drug works better than another in RA. Preliminary studies have attempted to address this. The Swedish Observational Study, for example, reported a lower drop-off rate and greater efficacy with regard to ACR 20 and 50 in patients taking etanercept compared with infliximab [ 22 ]. However, as with any observational study, there are many confounding variables and it is important not to over-interpret this.
However, these studies have been published so far only in abstract form. These observations are both important and intriguing. Amongst many potential factors, one with at least some supporting evidence is a recent report of a patient who responded to etanercept after failing on infliximab [ 28 ] and who had considerable expression of lymphotoxin on synovial biopsy.
In this case, the ability of etanercept but not infliximab to neutralize lymphotoxin is a compelling explanation. These drugs are effective, but there is also no doubt that they differ in many significant ways—from structure, through pharmacokinetics to clinical properties. Understanding the differences between these drugs in the laboratory is an important challenge for the future, not just to explain their differences in clinical settings, but also to stimulate new programmes of drug discovery and development, which may lead to newer generations of even more effective therapies.
The other authors have declared no conflicts of interest. Inhibitory effect of TNF alpha antibodies on synovial cell interleukin-1 production in rheumatoid arthritis. Lancet ; 2 : —7. Localization of tumor necrosis factor alpha in synovial tissues and at the cartilage—pannus junction in patients with rheumatoid arthritis.
Arthritis Rheum ; 34 : — Clin Exp Rheumatol ; 11 Suppl. Binding and functional comparisons of two types of tumor necrosis factor antagonists. J Pharmacol Exp Ther ; : — Cell ; 73 : — Arthritis Rheum ; 43 : Soluble tumor necrosis factor TNF receptors are effective therapeutic agents in lethal endotoxemia and function simultaneously as both TNF carriers and TNF antagonists.
J Immunol ; : — Cytokine ; 7 : —9. Enbrel, Humira, and Remicade are TNF inhibitors used to treat rheumatoid arthritis and other autoimmune diseases. They work by blocking immune system proteins that cause symptoms.
You can give yourself Enbrel and Humira injections using pre-filled injectable pens. Remicade requires an IV infusion. However, they have differing average durations of efficacy.
This refers to how long it takes for a medication to become less effective. Once a drug stops working as well as it should, it's usually necessary to switch to a new one. When it comes to Enbrel, Humira, and Remicade, research suggests Remicade has the shortest average duration of efficacy of the three. For example, in a study, both Enbrel and Humira had a duration of efficacy of more than seven years.
By comparison, Remicade had an average treatment duration of just over five years. What's more, of the three drugs, Enbrel's average duration of efficacy was especially high for men. The study also found older people on Enbrel were far less likely to change to another TNF biologic.
In considering drugs to change you to if what you are on loses its effectiveness, your doctor may also consider two additional TNF blockers: Cimzia certolizumab pegol and Simponi golimumab.
Even after factoring in health insurance co-payments, retails discounts, and patient assistance programs, you can expect the overall price of these drugs to fall more or less within these ranges:. It's worth factoring in the cost of each drug as you and your doctor decide which one you will try. With Remicade, it's also important to factor in the cost of having your medication administered at a hospital.
If you give yourself Enbrel or Humira, you obviously will not need to consider this expense. If you have rheumatoid arthritis, it's likely your doctor will want to prescribe a TNF inhibitor for you. Overall, these drugs are safe and effective, but there are a few factors to consider.
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