If you have rheumatoid arthritis (RA), you’re all too familiar with the kind of pain and joint stiffness that can make even getting out of bed in the morning a struggle.
Enbrel and Humira are prescription drugs used to treat RA.
Both of these drugs are tumor necrosis factor (TNF) alpha inhibitors. TNF alpha is a protein made by your immune system. It contributes to inflammation and joint damage.
Enbrel and Humira block the action of TNF alpha that leads to damage from abnormal inflammation.
Current guidelines don’t recommend TNF inhibitors as a first-line therapy for RA. Instead, they recommend treatment with a DMARD (such as methotrexate).
Besides RA, both Enbrel and Humira also treat:
In addition, Humira also treats:
- Crohn’s disease
- ulcerative colitis (UC)
- hidradenitis suppurativa, a skin condition
- uveitis, inflammation in the eye
Enbrel and Humira work in the same way to treat RA, and many of their features are the same.
Guidelines don’t express preference for one TNF inhibitor over the other, due to a lack of convincing evidence that one is more effective than the other.
Some people do benefit from switching to a different TNF inhibitor if the first doesn’t work, but most doctor’s would recommend switching to a different RA drug instead.
The following table highlights the features of these two drugs:
|What’s the generic name of this drug?||etanercept||adalimumab|
|Is a generic version available?||no||no|
|What form does this drug come in?||injectable solution||injectable solution|
|What strengths does this drug come in?||• 50-mg/mL single-use prefilled syringe|
• 50-mg/mL single-dose prefilled SureClick Autoinjector
• 50-mg/mL single-dose prefilled cartridge for use with AutoTouch autoinjector
• 25-mg/0.5 mL single-use prefilled syringe
• 25-mg multiple-dose vial
|• 80-mg/0.8 mL single-use prefilled pen|
• 80-mg/0.8 mL single-use prefilled syringe
• 40-mg/0.8 mL single-use prefilled pen
• 40-mg/0.8 mL single-use prefilled syringe
• 40-mg/0.8 mL single-use vial (institutional use only)
• 40-mg/0.4 mL single-use prefilled pen
• 40-mg/0.4 mL single-use prefilled syringe
• 20-mg/0.4 mL single-use prefilled syringe
• 20-mg/0.2 mL single-use prefilled syringe
• 10-mg/0.2 mL single-use prefilled syringe
• 10-mg/0.1 mL single-use prefilled syringe
|How often is this drug usually taken?||once per week||once per week or once every other week|
You may find that the Enbrel SureClick Autoinjector and Humira prefilled pens are easier and more convenient to use than prefilled syringes. They require fewer steps.
People will typically see some benefits of either drug after 2 to 3 doses, but an adequate trial of the drug is about 3 months to see their full benefit.
How each person responds to either drug will vary.
Enbrel and Humira are stored the same way.
Both should be kept in the original carton to protect from light or physical damage. Other storage tips are seen below:
- Keep the drug in a refrigerator at a temperature between 36°F and 46°F (2°C and 8°C).
- If traveling, keep the drug at room temperature (68–77°F or 20–25°C) for up to 14 days.
- Protect the drug from light and humidity.
- After 14 days at room temperature, throw the drug away. Don’t put it back in the refrigerator.
- Don’t freeze the drug or use if it has frozen and then thawed.
Enbrel and Humira are only available as brand-name drugs, not generics, and they cost about the same.
The website GoodRx can give you a more specific idea about their current, exact costs.
Many insurance providers require a prior authorization from your doctor before they’ll cover and pay for either of these drugs. Check with your insurance company or pharmacy to see if you need a prior authorization for Enbrel or Humira.
Your pharmacy can actually help you with the paperwork if authorization is needed.
Most pharmacies carry both Enbrel and Humira. However, it’s a good idea to call your pharmacy in advance to make sure your drug is in stock.
Biosimilars are available for both drugs. Once they become available, biosimilars may be more affordable than the original brand name drug.
The biosimilar of Enbrel is Erelzi.
Two biosimilars of Humira, Amjevita and Cyltezo, have been approved by the U.S. Food and Drug Administration (FDA). However, neither is currently available for purchase in the United States.
Amjevita became available in Europe in 2018, but it’s not expected to hit U.S. markets until 2023.
Enbrel and Humira belong to the same drug class. As a result, they have similar side effects.
Some of the more common side effects include:
More serious side effects can include:
- increased risk of cancer
- nervous system problems
- blood problems
- new or worsening heart failure
- new or worsening psoriasis
- allergic reactions
- autoimmune reactions
- serious infections
- suppression of the immune system
One study of 177 people did find that adalimumab, or Humira, users were over three times as likely to report injection/infusion-site burning and stinging after six months of treatment.
Always let your doctor know about all medications, vitamins, or herbs you’re taking. This can help your doctor prevent possible drug interactions, which can change the way your drug works.
Interactions can be harmful or prevent the drugs from working well.
Enbrel and Humira interact with some of the same drugs. Using either Enbrel or Humira with the following vaccines and drugs increases your risk of infection:
- Live vaccines, such as:
- Certain cancer drugs, such as cyclophosphamide and methotrexate
- Some other RA drugs such as sulfasalazine
- Certain drugs that are processed by a protein called cytochrome p450, including:
If you have hepatitis B virus infection, taking Enbrel or Humira could activate your infection. That means you could start to experience hepatitis B symptoms, such as:
- lack of appetite
- yellowing of your skin or the whites of your eyes
- pain on the right side of your stomach
Enbrel and Humira are very similar drugs. They’re equally effective at relieving the symptoms of RA.
However, there are slight differences, some of which might make one more convenient for you to use.
For instance, Humira can be taken every other week or weekly, while Enbrel can only be taken weekly. You may also find that you prefer certain applicators, such as pens or autoinjectors. That preference may determine which medication you choose.
Knowing a little more about these two drugs can help you talk with your doctor to find out if either of them is an option for you.