Etanercept should be used in accordance with guidelines produced by the british society for rheumatology.
The use of anti-TNF agents and the occurrence of severe sepsis and re-activation of tuberculosis has been reported. Their use should be avoided if serious infections (e.g. septic arthritis, acute abcess, systemic fungal infactions) are present or are likely to recur.
The manufacturer of etanercept suggests caution in patients with a history of recurring infection or a medical condition that predisposes to infection.
Etanercept has been rarely associated with severe leucopenia, pancytopenia, aplastic anaemia and the onset of CNS demyelination. Caution is advised in patients with any history of these disorders and should they recur, therapy should be stopped. All patients should be advised of the risks and features of blood dyscrasias or demyelination.
Vaccinations should be brought up to date before starting etanercept, particularly in children.
Etanercept should be avoided in pregnancy and effective contraceptive measures should be taken. Etanercept may not be used in breast feeding women.
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