How long does Enbrel take to work?

Enbrel is a type of biologic drug. It’s a branded medication that helps treat certain autoimmune conditions. The generic form is called etanercept.

It binds to specific cellular proteins that cause joint inflammation and blocks their activity. Enbrel is Food and Drug Administration (FDA) approved for several conditions, including rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, juvenile arthritis, and ankylosing spondylitis. 

Enbrel is an injectable drug that you take once or twice a week, depending on the dose and indication. It can take up to 3 months to experience your full response to the drug. Although there is clinical research to show Enbrel’s efficacy, it doesn’t work for everyone. It can also stop working after it has helped reduce symptoms.

Alternative biologics, as well as biosimilars to Enbrel, are other options.   

How long does it take to work?

According to the company that makes Enbrel, some people with rheumatoid arthritis experienced reduced joint pain, swelling, and stiffness in as little as 1–2 weeks of taking the medication. People nearly always saw an improvement after 3 months of treatment.

A 2018 review of clinical data for etanercept in rheumatoid arthritis surveyed the drug trials at the time of the drug’s initial FDA approval in 1998 and the following years. Based on this clinical data from 1999–2008, etanercept has similar efficacy to methotrexate after 1 year for people with early stage rheumatoid arthritis. 

One study cited by the 2018 review showed a greater response than methotrexate for etanercept at 24 weeks, possibly indicating it works faster than the other medication. According to the review, combination methotrexate and etanercept therapy works better than using either medication alone.

It’s important to note that if you stop taking Enbrel, your symptoms are likely to return.

Factors that can affect it 

Enbrel doesn’t work for everyone. It is part of a class of drugs called tumor necrosis factor (TNF) inhibitors.

According to the Arthritis Foundation, about one-third of people who try a TNF inhibitor for rheumatoid arthritis don’t experience results with the first drug in this class they try. In as many as half of those who do experience results, the medication eventually stops working.

There are many possible reasons why a biologic such as Enbrel might not work for you. A 2023 study found that people with rheumatoid arthritis can develop antibodies to the biologic drugs — including Enbrel — used to treat the condition.

The Arthritis Foundation also noted other possible reasons for biologic treatment failure, such as:

• genetic changes
• older age
• more severe rheumatoid arthritis disease 

Although the Arthritis Foundation also noted that smoking might affect whether a biologic works, some research contradicts this. A 2021 study of 109 people treated for psoriasis with biologics, including etanercept, found no difference in drug efficacy based on smoking status. 

A 2018 review of studies of TNF inhibitors, including etanercept, to treat immune-mediated inflammatory diseases suggests obesity might be a factor in biologic efficacy. The review found that people with obesity were 60% more likely to find the biologic doesn’t work. 

Enbrel alternatives 

Alternatives to Enbrel include other TNF inhibitors. They also include biosimilar products.

Biosimilars are products the FDA has found have no clinically meaningful differences from the original reference drug. A biosimilar is not a generic drug — researchers create biologics from living elements that they cannot exactly copy like they might copy the formula for a drug.

Other TNF inhibitors besides Enbrel include:

• adalimumab (Humira)
• certolizumab pegol (Cimzia)
• golimumab (Simponi, Simponi Aria) 
• infliximab (Remicade)

There are also several biosimilars for both adalimumab (Humira) and infliximab (Remicade). 

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Summary

Etanercept (Enbrel) is a biologic drug with FDA approval to treat several conditions, such as rheumatoid arthritis and plaque psoriasis. Enbrel can start to work as early as 1–2 weeks after treatment, but most people experience a reduction in symptoms at 3 months. 

Enbrel does not work for everyone. The medication can also stop working after some time. Alternatives to Enbrel include other drugs in the same class of TNF inhibitors. There are also biosimilar products to etanercept with FDA approval.

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