Otezla vs. Enbrel for Plaque Psoriasis and Psoriatic Arthritis: Important Differences and Potential Risks.

Key takeaways

Otezla (apremilast) and Enbrel (etanercept) are both used to treat autoimmune conditions, but they have some key differences. Otezla is a tablet taken daily, while Enbrel is given as an injection. Otezla is available in a generic form, but it likely won't be on the market until at least 2028, whereas Enbrel is only available as a brand-name product and can be expensive. Otezla is used for conditions like psoriasis, psoriatic arthritis, and Behçet’s disease, while Enbrel treats rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and childhood arthritis. Otezla can cause side effects like nausea, diarrhea, and weight loss, while Enbrel can increase the risk of serious infections and certain cancers.

Otezla

(apremilast)

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Enbrel

(etanercept)

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Summary for Otezla

Prescription only

Otezla (apremilast) is a tablet that's taken by mouth. It treats plaque psoriasis and psoriatic arthritis in people 6 years and older. The medication can also treat mouth sores from Behçet’s disease in adults. It works as a phosphodiesterase-4 (PDE4) inhibitor to reduce inflammation. Immediate-release tablets called Otezla are taken twice daily. You start at a low dose, then it gets raised over a few days to a maintenance dose. Some people can switch to once-daily, extended-release tablets called Otezla XR. Side effects include nausea and diarrhea.

Indications for Otezla

Psoriatic arthritis in people 6 years and older
Plaque psoriasis in people 6 years and older
Mouth sores from Behçet’s disease in adults

Pros and Cons for Otezla

Pros

Taken by mouth
Can take with or without food
Option to switch to once-daily extended-release tablets for some people

Cons

Dosing schedule can be confusing in the beginning
Common to have nausea or diarrhea when starting
Might not be a good option for people who've had depression or suicidal behavior

Common Side Effects for Otezla

Diarrhea (17%)
Nausea (17%)
Upper respiratory tract infection (e.g., common cold; 9%)
Headache (up to 8%)

Warnings for Otezla

Allergic reaction
Diarrhea, nausea, and vomiting
Depression
Possible weight loss
Drug interactions

Summary for Enbrel

Prescription only

Enbrel (etanercept) is a weekly injection used for many autoimmune conditions. Currently, it's only available as a brand-name product and can be expensive.

Indications for Enbrel

Rheumatoid arthritis (RA)
Plaque psoriasis (PsO) and psoriatic arthritis (PsA)
Ankylosing spondylitis (AS)
Childhood arthritis (polyarticular juvenile idiopathic arthritis, JIA)

Pros and Cons for Enbrel

Pros

Available in a prefilled syringe or autoinjector for easy-at-home injections
Can be used in children age 2 and older for certain indications (JIA)
Can be kept at room temperature for up to 14 days
Manufacturer offers copay card for people with commercial insurance
Not many side effects other than infection and redness and irritation at the injection site

Cons

Raises risk of serious infections
Can cause the hepatitis B virus to reappear if you have a history of infection
Lymphoma and other cancers have been reported in people taking Enbrel (etanercept)
Available only as a brand medication so it can be expensive and isn't always covered by insurance
Needs to be given every week, unlike Humira (adalimumab), which is given every other week