Comparative Pharmacology
Head-to-head clinical analysis: ENBREL versus REMICADE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ENBREL versus REMICADE.
ENBREL vs REMICADE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Tumor necrosis factor (TNF) inhibitor; etanercept is a dimeric fusion protein consisting of the extracellular ligand-binding portion of human TNF receptor p75 linked to the Fc portion of human IgG1. It binds to soluble and membrane-bound TNF, thereby blocking TNF-mediated inflammatory responses.
Infliximab is a chimeric monoclonal IgG1 antibody that binds with high affinity to tumor necrosis factor alpha (TNFα), neutralizing its pro-inflammatory cytokine activity by preventing its interaction with p55 and p75 cell surface TNF receptors.
50 mg subcutaneous injection once weekly
5 mg/kg IV at weeks 0, 2, and 6, then every 8 weeks thereafter; for rheumatoid arthritis, may increase to 10 mg/kg every 8 weeks if needed.
None Documented
None Documented
Approximately 102 hours (range 68–170 hours) after subcutaneous administration in adults; prolonged in elderly and patients with renal impairment; supports every 2-week dosing.
Terminal elimination half-life is approximately 7.7 to 9.5 days (range 7-12 days). The prolonged half-life supports every-8-week dosing; may be shorter in patients with high tumor burden or immunogenicity.
Renal: negligible; Biliary/Fecal: not significantly eliminated; primarily degraded via proteolysis into amino acids.
Infliximab is eliminated primarily via the reticuloendothelial system. No significant renal or biliary excretion; less than 0.1% of dose excreted unchanged in urine. Clearance is mainly through proteolytic catabolism.
Category C
Category C
TNF-alpha Inhibitor
TNF-alpha Inhibitor