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etanercept

Modality
fusion protein
Mechanism
12.1 Mechanism of Action TNF is a naturally occurring cytokine that is involved in normal inflammatory and immune responses. It plays an important role in the inflammatory processes of RA, polyarticular JIA, PsA, and AS and the resulting joint pathology. In addition, TNF plays a role in the inflammatory process of PsO. Elevated levels of TNF are found in involved tissues and fluids of patients with RA, JIA, PsA, AS, and PsO. Two distinct receptors for TNF (TNFRs), a 55 kilodalton protein (p55) and a 75 kilodalton protein (p75), exist naturally as monomeric molecules on cell surfaces and in soluble forms. Biological activity of TNF is dependent upon binding to either cell surface TNFR. Etanercept is a dimeric soluble form of the p75 TNF receptor that can bind TNF molecules. Etanercept inhibits binding of TNF-α and TNF-β (lymphotoxin alpha [LT-α]) to cell surface TNFRs, rendering TNF biologically inactive. In in vitro studies, large complexes of etanercept with TNF-α were not detected and cells expressing transmembrane TNF (that binds Enbrel) are not lysed in the presence or absence of complement.
Targets
TNF-α, TNF-β (LT-α)
Storage
Approved
psoriasis — FDA
In trial
psoriasis, chronic urticaria, atopic dermatitis, vitiligo, hidradenitis suppurativa
Sources
Last verified
2026-04-23
No curated MOA diagram yet. See lib/moa-data.ts for the shape; add an entry keyed by etanercept.

Monitoring & workup

Baseline workup

  • TB IGRA (or PPD) + CXR
  • HBV sAg + core Ab + surface Ab; HCV Ab
  • CBC with differential
  • CMP
  • Update age-appropriate vaccines including live vaccines before start

Ongoing monitoring

  • Symptom-driven; no routine labs
  • Annual TB screening if high exposure risk
  • Monitor for serious infection, reactivation (TB/HBV), demyelinating disease, paradoxical psoriasis