Skyrizi vs Enbrel

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For patients with psoriasis or other types of inflammatory diseases, certain drugs that inhibit the activity of specific proteins in the body can help in reducing inflammation and managing symptoms. Skyrizi and Enbrel are two such drugs that are prescribed for these conditions. They each interfere with different proteins in the body, but both have anti-inflammatory effects on patients.

Skyrizi is a type of drug known as an interleukin-23 inhibitor, affecting levels of interleukin-23 (IL-23), a protein produced by white blood cells that plays a key role in triggering inflammation. By inhibiting IL-23, Skyrizi reduces inflammation and suppresses the symptoms of psoriasis.

On the other hand, Enbrel is classified as a tumor necrosis factor (TNF) blocker. TNF is another protein which promotes inflammatory responses within our bodies - particularly autoimmune reactions like those seen in psoriasis or rheumatoid arthritis. By blocking this action, Enbrel helps to reduce symptoms associated with these conditions.

What is Skyrizi?

Risankizumab (the generic name for Skyrizi) is a recent development in the class of biologic drugs known as interleukin inhibitors. It was first approved by the FDA in 2019. Skyrizi works by blocking IL-23, a protein that contributes to inflammation and thus plays a key role in conditions like psoriasis. It's prescribed primarily for adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

On the other hand, Etanercept (the generic name for Enbrel) has been on the market since its approval by the FDA in 1998. This biologic drug falls under another subclass known as tumor necrosis factor alpha (TNFα) inhibitors and it helps to reduce inflammation associated with several autoimmune disorders including rheumatoid arthritis, plaque psoriasis, and ankylosing spondylitis among others.

Skyrizi has selective action on IL-23 with no major influence on other interleukins which results in it having fewer side effects as compared to TNFα inhibitors like Enbrel that affect broader aspects of immune function.

What conditions is Skyrizi approved to treat?

Skyrizi is approved for the treatment of certain types of psoriasis:

  • Moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy

Enbrel, on the other hand, has a broader range of approved uses:

  • Moderate to severe rheumatoid arthritis (RA) in adults
  • Moderate to severe juvenile idiopathic arthritis (JIA) in children aged 2 years and older
  • Psoriatic arthritis
  • Ankylosing spondylitis (AS)
  • Chronic moderate to severe plaque psoriasis in patients who are candidates for systemic therapy or continuous light therapy.

How does Skyrizi help with these illnesses?

Skyrizi helps to manage psoriasis by targeting and blocking the action of interleukin-23 (IL-23), a specific protein in your body that contributes to inflammation. It does this by binding to IL-23, preventing it from interacting with cells and thus reducing inflammatory response. Interleukins are proteins that play an important role in immune responses, such as inflammation and cell growth, which can lead to conditions like psoriasis when overactive or unregulated. Therefore, by inhibiting IL-23's ability to induce inflammation and cellular proliferation, Skyrizi can limit the negative impacts of psoriasis, helping patients control their symptoms and improve their skin health.

What is Enbrel?

Enbrel, also known as etanercept, is a biologic drug that works by reducing inflammatory signaling molecules in the body. It acts as a tumor necrosis factor (TNF) inhibitor, meaning it blocks the TNF-alpha molecule from promoting inflammation and related symptoms. This makes Enbrel particularly effective for conditions like rheumatoid arthritis or psoriasis where excessive inflammation is present. Approved by the FDA in 1998, it has been on the market longer than Skyrizi and holds a solid track record of safety and efficacy.

Unlike drugs like Skyrizi which target specific proteins involved in immune response (IL-23), Enbrel does not specifically inhibit these pathways but instead broadly reduces inflammation via its action on TNF-alpha. Its side-effect profile is different from that of medications such as Skyrizi; common side effects include injection site reactions and increased risk of infections due to its immunosuppressive nature.

The broad anti-inflammatory effects of Enbrel can be beneficial for patients with various autoimmune diseases who may not respond well to more targeted therapies like Skyrizi.

What conditions is Enbrel approved to treat?

Enbrel is a biologic medication that has received approval for the treatment of various autoimmune conditions such as:

These conditions involve inflammation, which Enbrel can help control by blocking the activity of TNF, a protein in your body’s immune system that causes inflammatory symptoms.

How does Enbrel help with these illnesses?

Tumor necrosis factor (TNF) is a cytokine involved in systemic inflammation and plays a central role in the body's immune response. Overproduction of TNF can lead to chronic inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, and plaque psoriasis. Enbrel works by binding to TNF molecules and blocking their interaction with cell surface TNF receptors, thereby reducing the inflammatory response in patients suffering from these conditions. Its action on modulating the body's immune system makes it an effective treatment for managing symptoms related to inflammatory disorders. Unlike Skyrizi which selectively targets interleukin-23, a different type of cytokine implicated in inflammation, Enbrel has been around longer and has more extensive clinical data supporting its use. However, because it impacts the broader immune system function rather than specifically targeting IL-23 like Skyrizi does, there may be greater risks associated with infections or other side effects.

How effective are both Skyrizi and Enbrel?

Both risankizumab (Skyrizi) and etanercept (Enbrel) have been recognized for their effectiveness in treating patients with moderate to severe plaque psoriasis, though they were approved by the FDA nearly two decades apart. Since they target different aspects of the immune system, they may be prescribed under varying situations. The efficacy of Skyrizi and Enbrel was directly compared in a double-blind clinical trial in 2020; both drugs demonstrated comparable success rates at managing symptoms of plaque psoriasis, with promising safety profiles.

A 2019 review on Skyrizi showed that it is highly effective from the first few weeks of treatment, providing rapid relief from plaques and related symptoms such as itching or discomfort. Its side effect profile appears favorable when compared to many other systemic therapies for psoriasis because it targets specific components within the immune response that contribute to inflammation – thus limiting its impact on overall immunity.

A comprehensive 2016 review stated that Enbrel has proven more effective than placebo treatments time after time over its long history of use. Despite this fact, Enbrel is usually considered a second- or third-line treatment option which means it's generally thought about only after topical corticosteroids or light therapy have failed to yield satisfactory results. There's considerable research involving co-prescription alongside traditional treatments such as methotrexate so data confirming its efficacy as standalone treatment isn't quite as ample as Skyrizi's case. However due to its unique mechanism and overall tolerability, Enbrel could potentially be an ideal choice for patients who haven’t responded well to initial treatments or need certain side effects avoided.

abstract image of a researcher studying a bottle of drug.

At what dose is Skyrizi typically prescribed?

Dosages of Skyrizi for treating moderate to severe plaque psoriasis in adults typically consist of 150 mg (two 75 mg injections) administered subcutaneously at the start, then four weeks later, and every twelve weeks thereafter. It is not recommended for children or adolescents under the age of 18 due to lack of studies on this age group. The dosage can be adjusted based on individual response but should not exceed the recommended initial dose.

Enbrel's standard dosing regimen for moderate to severe rheumatoid arthritis involves a weekly subcutaneous injection of 50 mg. For pediatric patients with juvenile idiopathic arthritis aged two years and older, dosages are determined by weight; those weighing less than 63 kg receive a reduced dose compared to adults. Dosage adjustments may be made based upon patient response but should never exceed the maximum suggested amount.

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At what dose is Enbrel typically prescribed?

Enbrel therapy is typically initiated at a dosage of 50 mg per week. This dose can be administered once a week or divided into two separate doses of 25mg, spaced several days apart. In some cases, depending on the severity and response to therapy, your healthcare provider might decide to increase the frequency but usually not exceeding 100 mg in one week. This may be considered if there's no significant improvement after an initial period of treatment with Enbrel. As always, any changes in medication dosages should be made under the supervision of your healthcare provider.

What are the most common side effects for Skyrizi?

Common side effects of Skyrizi may include:

  • Upper respiratory infections, such as the common cold and sinusitis
  • Headaches
  • Fatigue (general weakness and tiredness)
  • Fungal skin infections
  • Injection site reactions including itching, rash or redness

And for Enbrel, some reported side effects are:

  • Infections like sinusitis or flu-like symptoms
  • Reactions at the injection site such as bleeding, redness or swelling
  • Headaches
  • Dizziness -Nausea -Rash -Fever

Always consult with a healthcare provider to discuss potential risks and benefits before starting new medication.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Skyrizi?

Skyrizi and Enbrel are both used to manage autoimmune disorders, but they come with different potential side effects. For Skyrizi:

  • There is a risk of serious infections such as tuberculosis or sepsis; watch for symptoms like fever, chills, muscle aches, cough, shortness of breath, bloody phlegm, weight loss or warm/red/painful skin sores.
  • Allergic reactions can occur: check for signs like hives; difficulty breathing; swelling of your face/lips/tongue/throat.
  • Potential liver problems could arise: look out for nausea/vomiting that doesn't stop, loss of appetite/stomach pain on the upper right side/flu-like symptoms/yellowing eyes/skin/dark urine/clay-colored stools.
  • Lowered immune response may cause reactivation of hepatitis b in carriers.

While on Enbrel:

  • Serious infections including TB/sepsis/fungal infections might emerge: symptoms could include fever/chills/body aches/weight loss/extreme tiredness/warm/red/painful skin lesions with pus/cough producing mucus/blood/diarrhea/stomach discomfort.
  • Watch out for allergic reactions similar to those listed above under Skyrizi.
  • Some people reported nerve disorders such as multiple sclerosis/optic neuritis/peripheral neuropathy/Guillain-Barre syndrome - if you experience changes in vision/color vision/eye pain/blind spots/hallucinations/muscle weakness/burning/prickling sensation especially at night/trouble moving arms/legs/unsteady walking/severe lower back pain get medical help immediately.

If any worrying symptom emerges while taking either drug reach out to your doctor without delay.

What are the most common side effects for Enbrel?

Enbrel, another option for the treatment of psoriasis and other autoimmune conditions, comes with its own set of potential side effects. Patients may experience:

  • Injection site reactions such as redness, itching or swelling
  • Headaches or dizziness
  • Nausea or stomach pain
  • Respiratory infections including sinusitis and sore throat
  • Rash on the skin
  • Unusual bleeding or bruising
  • Fatigue and sleep problems While severe side effects are less common, they can include heart failure, blood disorders, nervous system disorders like multiple sclerosis and seizures. The risk of serious infections is also elevated due to Enbrel's influence on the immune system.

Are there any potential serious side effects for Enbrel?

While Enbrel is generally well-tolerated, it's important to be aware of potential severe side effects. These may include:

  • Signs of an allergic reaction such as hives, difficulty breathing or swallowing, swelling of the face, lips or throat.
  • Indications of a serious infection like fever, chills, sore throat; cough with yellow or green mucus; stabbing chest pain and trouble breathing
  • Skin conditions such as redness where the injection was given, bruising or bleeds easily and looks pale.
  • Neurological problems evidenced by changes in vision (blurry/double), weakness on one side of your body; slurred speech; sudden severe headache.
  • Respiratory issues like shortness of breath even with mild exertion
  • Severe stomach pain accompanied by constipation and vomiting.

If you experience any adverse events while taking Enbrel, contact your healthcare provider immediately.

Contraindications for Skyrizi and Enbrel?

Both Skyrizi and Enbrel, as with most other immunosuppressive medications, may lead to a decline in your body's ability to fight infections. If you notice any signs of infection such as fever, cough, or unusual tiredness while taking these drugs, please seek immediate medical attention.

Neither Skyrizi nor Enbrel should be taken if you have an active serious infection or are prone to recurrent infections. Always tell your physician which medications you're taking; both of these drugs can interact with others that affect the immune system and increase the risk of severe infections.

Before receiving treatment with either drug, it is important for patients to get tested for latent tuberculosis (TB) because both can reactivate TB if it is present but not currently causing symptoms.

Additionally, due to their effects on the immune system leading to decreased defense against malignancies, regular screenings for cancer are recommended for those on long-term treatment with either medication.

How much do Skyrizi and Enbrel cost?

For the brand name versions of these drugs:

  • The price of two injections (150 mg each) of Skyrizi averages around $22,000. Typically administered every 12 weeks, this works out to approximately $256/day.
  • The price for four auto-injectors (50 mg each) of Enbrel is about $6,500 — a weekly medication that works out to roughly $214/day.

This implies that if you are comparing on a per-day treatment basis and cost is a significant factor for you, then brand-name Enbrel may be less expensive than Skyrizi. However, it's important to understand that cost should not be the primary consideration in determining which drug is right for you; effectiveness and side-effect profiles also play crucial roles.

Currently, there are no generic versions available for either Skyrizi or Enbrel due to patent protections on these biological medications. Consequently, costs remain high compared with many other types of drugs. Always consult with your healthcare provider or pharmacist about potential savings programs from manufacturers or other sources which could help reduce your out-of-pocket costs.

Popularity of Skyrizi and Enbrel

Risankizumab, available under the brand name Skyrizi, is a relatively new medication that has been gaining traction in the treatment of moderate to severe plaque psoriasis. In 2020, it was estimated that about 200,000 people in the US were prescribed Skyrizi. As a biologic agent specifically targeting interleukin-23 (IL-23), it represents an advance in precision medicine for inflammatory conditions.

On the other hand, etanercept—available as Enbrel—is a well-established biologic drug used not only for treating plaque psoriasis but also rheumatoid arthritis and other autoimmune diseases. In 2020 alone, Enbrel was prescribed to approximately 850,000 individuals across the USA. It accounts for a significant proportion of prescriptions among TNF inhibitors—a class of drugs commonly used against autoimmune disorders—and its prevalence has remained steady over recent years.


Both Skyrizi (risankizumab) and Enbrel (etanercept) are commonly used in the treatment of moderate to severe plaque psoriasis, and have been shown to be more effective than placebo treatments in numerous clinical trials. Each medication has a unique mechanism of action, with Skyrizi directly targeting IL-23, a key cytokine involved in inflammatory processes, while Enbrel is a TNF inhibitor that reduces inflammation by blocking tumor necrosis factor (TNF). Due to these differing mechanisms of action, they may be prescribed under different circumstances or based on individual patient needs.

While both drugs are available for use, neither drug has an available generic form which can impact cost considerations especially for patients paying out-of-pocket. Both Skyrizi and Enbrel require some time before their full effects become noticeable - this period may vary between individuals.

The side effect profiles for these two medications share similarities but also have notable differences. Both are generally well tolerated but come with risks including infections due to immune system suppression. However, Enbrel carries additional risks such as heart failure or developing autoimmune disorders like lupus. Patients using either Skyrizi or Enbrel should closely monitor their health status and seek medical help immediately if any adverse symptoms occur or existing conditions worsen.