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Arthritis and Rheumatism

Is Humira More Effective Than Enbrel?

06/05/2008

Question:

Is Humira a stronger drug than Enbrel?

Answer:

In the setting of treating Rheumatoid Arthritis (RA) affecting humans, there have been no head-to-head studies comparing the effectiveness of adalimumab (Humira) versus etanercept (Enbrel). Therefore, it is not possible to definitively state whether or not one medicine is "stronger" than the other in RA. If one compares studies that solely report the response of RA patients to adalimumab to studies that solely report the response of RA patients to etanercept, the percent of people that respond to these medicines is fairly similar.

Both adalimumab and etanercept work by blocking the effects of an agent known as TNF-alpha. However, the medicines inhibit TNF-alpha in different ways. In the April 2008 issue of Arthritis and Rheumatism, Hitoma, et al, describe how adalimumab attacks TNF-alpha through an innate immunity mechanism as well as an antibody-dependent mechanism while etanercept demonstrates mainly an antibody-dependent mechanism. It is not clear that these different mechanisms confer more "strength" in treating RA in humans.

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University