natgillin/translations-raw huggingface dataset:
12 vials + 12 pre-filled syringes + 12 needles + 12 vial adaptors + 24 swabs
12 viale + 12 napolnjene injekcijske brizge + 12 igle + 12 adapterje za viale + 24 alkoholnih tamponov
powder and solvent for solution for injection for paediatric use
prašek in vehikel za raztopino za injiciranje za uporabo pri otrocih
4 vials + 4 pre-filled syringes + 8 empty syringes + 20 needles + 24 alcohol swabs
4 viale + 4 napolnjene injekcijske brizge + 8 praznih injekcijkih brizg 20 igle + 24 alkoholnih tamponov
syringe (glass)
steklena injekcijska brizga
4 pre-filled syringes + 8 alcohol swabs
4 napolnjene injekcijske brizge + 8 alkoholnih tamponov
8 pre-filled syringes + 16 alcohol swabs
8 napolnjene injekcijske brizge + 16 alkoholnih tamponov
24 pre-filled syringes + 48 alcohol swabs
24 napolnjene injekcijske brizge + 48 alkoholnih tamponov
syringe (glass)
Injekcijska brizga (steklo)
2 pre-filled syringes + 4 alcohol swabs
2 napolnjene injekcijske brizge + 4 alkoholnih tamponov
4 pre-filled syringes + 8 alcohol swabs
4 napolnjene injekcijske brizge + 8 alkoholni tamponi
12 pre-filled syringes + 24 alcohol swabs
12 napolnjene injekcijske brizge + 24 alkoholnih tamponov
Etanercept is a human tumour necrosis factor receptor p75 Fc fusion protein produced by recombinant DNA technology in a Chinese hamster ovary (CHO) mammalian expression system.
Pridobljen je z rekombinantno DNA tehnologijo na razplodnem sistemu pri sesalcih, in sicer v celicah jajčnika kitajskega hrčka (CHO – » Chinese hamster ovary «).
Etanercept is a dimer of a chimeric protein genetically engineered by fusing the extracellular ligand binding domain of human tumour necrosis factor receptor-2 (TNFR2/ p75) to the Fc domain of human IgG1.
Etanercept je dimer himerne beljakovine, ustvarjen z genskim inženirstvom s spajanjem zunajceličnega vezalnega predela receptorja- 2 za tumorje nekrotizirajoči faktor (TNFR2/ p75) in Fc predela humanega imunoglobulina IgG1.
This Fc component contains the hinge, CH2 and CH3 regions but not the CH1 region of IgG1.
Fc predel humanega IgG1 vsebuje "tečajna" področja CH2 in CH3, ne pa tudi CH1 področja IgG1.
The potency is determined by measuring the ability of etanercept to neutralise the TNF -mediated growth inhibition of A375 cells.
Jakost etanercepta določamo s stopnjo nevtralizacije inhibicije rasti A375 celic, ki jo povzroča TNFalfa.
The specific activity of etanercept is 1.7 x 106 units/ mg.
Specifična aktivnost etanercepta je 1, 7 x 106 enot/ mg.
Enbrel in combination with methotrexate is indicated for the treatment of moderate to severe active rheumatoid arthritis in adults when the response to disease-modifying antirheumatic drugs, including methotrexate (unless contraindicated), has been inadequate.
Zdravilo Enbrel je v kombinaciji z metotreksatom indicirano za zdravljenje zmernega do hudega aktivnega revmatoidnega artritisa pri odraslih, kadar odziv na zdravljenje z imunomodulirajočimi protirevmatičnimi zdravili, vključno z metotreksatom (če ta ni kontraindiciran), ni zadosten.
Enbrel, alone or in combination with methotrexate, has been shown to reduce the rate of progression of joint damage as measured by X-ray and to improve physical function.
Dokazano je, da zdravilo Enbrel samo ali v kombinaciji z metotreksatom upočasni napredovanje poškodb sklepov, merjenih z rentgenskim slikanjem, in izboljša telesno funkcijo.
2 Polyarticular juvenile idiopathic arthritis
Poliartikularni juvenilni idiopatski artritis
Treatment of active polyarticular juvenile idiopathic arthritis in children and adolescents from the age of 4 years who have had an inadequate response to, or who have proved intolerant of, methotrexate.
Zdravljenje aktivnega poliartikularnega juvenilnega idiopatskega artritisa pri otrocih in mladostnikih od 4. leta starosti naprej, ki so se nezadostno odzvali na metotreksat ali pa ga niso prenašali.
Enbrel has not been studied in children aged less than 4 years.
Zdravila Enbrel niso preizkušali pri otrocih, mlajših od 4 let.
Psoriatic arthritis
2 Psoriatični artritis
Treatment of active and progressive psoriatic arthritis in adults when the response to previous disease- modifying antirheumatic drug therapy has been inadequate.
Zdravljenje aktivnega in progresivnega psoriatičnega artritisa pri odraslih, če je bil odziv na zdravljenje z imunomodulirajočimi protirevmatičnimi zdravili nezadosten.
Enbrel has been shown to improve physical function in patients with psoriatic arthritis, and to reduce the rate of progression of peripheral joint damage as measured by X-ray in patients with polyarticular symmetrical subtypes of the disease.
Izkazalo se je, da zdravilo Enbrel izboljša telesno funkcijo pri bolnikih s psoriatičnim artritisom in da upočasni hitrost napredovanja okvar perifernih sklepov, izmerjeno z rentgenskim slikanjem, pri bolnikih s poliartikularnimi simetričnimi podvrstami bolezni.
Treatment of adults with moderate to severe plaque psoriasis who failed to respond to, or who have a contraindication to, or are intolerant to other systemic therapy including cyclosporine, methotrexate or PUVA (see Section 5.1).
Zdravljenje zmerne do hude psoriaze v plakih pri odraslih, ki se ne odzovejo na drugo sistemsko zdravljenje, vključno s ciklosporinom, metotreksatom ali PUVA, oziroma je pri njih drugo zdravljenje kontraindicirano ali ga ne prenašajo (glejte poglavje 5. 1).
Treatment of chronic severe plaque psoriasis in children and adolescents from the age of 8 years who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies.
Zdravljenje težke kronične psoriaze v plakih pri otrocih in mladostnikih od 8. leta starosti naprej, pri katerih se z drugo sistemsko terapijo ali fototerapijo bolezen ne da zadostno obvladati ali je bolniki ne prenašajo.
Enbrel treatment should be initiated and supervised by specialist physicians experienced in the diagnosis and treatment of rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis or paediatric plaque psoriasis.
Zdravljenje z zdravilom Enbrel lahko uvede in nadzoruje le zdravnik specialist, ki ima izkušnje z diagnosticiranjem in zdravljenjem revmatoidnega artritisa, juvenilnega idiopatskega artritisa, psoriatičnega artritisa, ankilozirajočega spondilitisa, psoriaze v plakih ali otroške psoriaze v plakih.
Patients treated with Enbrel should be given the Patient Alert Card.
Bolniki, ki se zdravijo z zdravilom Enbrel, naj prejmejo opozorilno kartico bolnika.
Enbrel is available in strengths of 25 and 50 mg.
Zdravilo Enbrel je na voljo v jakostih 25 in 50 mg.
Comprehensive instructions for the preparation and administration of the reconstituted Enbrel vial are given in the package leaflet, section 7, "Instructions for preparation and giving an injection of Enbrel."
Izčrpna navodila za pripravo in aplikacijo pripravljene viale zdravila Enbrel so navedena v navodilu za uporabo, poglavje 7, "Navodila za pripravo in dajanje injekcij zdravila Enbrel".
Adults (18-64 years)
Odrasli (18 do 64 let)
Alternatively, 50 mg administered once weekly has been shown to be safe and effective (see section 5.1).
Druga možnost je dajanje 50 mg enkrat na teden; dokazano je, da je ta možnost varna in učinkovita (glejte poglavje 5. 1).
3 Psoriatic arthritis and ankylosing spondylitis
Psoriatični artritis in ankilozirajoči spondilitis
Alternatively, 50 mg given twice weekly may be used for up to 12 weeks followed, if necessary, by a dose of 25 mg twice weekly or 50 mg once weekly.
Do 12 tednov je mogoče uporabljati tudi 50 mg dvakrat na teden, čemur sledi odmerek 25 mg dvakrat na teden ali 50 mg enkrat na teden, če je to potrebno.
Treatment with Enbrel should continue until remission is achieved, for up to 24 weeks.
Zdravljenje z zdravilom Enbrel mora trajati, dokler ne dosežemo remisije, vendar največ 24 tednov.
If re-treatment with Enbrel is indicated, the above guidance on treatment duration should be followed.
3 V primeru ponovnega zdravljenja z zdravilom Enbrel je potrebno upoštevati zgornja navodila glede trajanja zdravljenja.
Elderly patients ( 65 years)
Starostniki (≥ 65 let)
Juvenile idiopathic arthritis (age 4 years and above)
Juvenilni idiopatski artritis (starost 4 leta in več)
0.4 mg/ kg (up to a maximum of 25 mg per dose) after reconstitution of 25 mg Enbrel in 1 ml of solvent, given twice weekly as a subcutaneous injection with an interval of 3-4 days between doses.
0, 4 mg/ kg telesne mase (do največ 25 mg na odmerek) po rekonstituciji 25 mg zdravila Enbrel v 1 ml vehikla, dano 2- krat tedensko v obliki subkutane injekcije z razmikom med odmerki od 3 do 4 dni.
Paediatric plaque psoriasis (age 8 years and above)
Otroška psoriaza v plakih (starost 8 let in več)
0.8 mg/ kg (up to a maximum of 50 mg per dose) once weekly for up to 24 weeks.
0, 8 mg/ kg (do največ 50 mg na odmerek) enkrat na teden do največ 24 tednov.
The dose should be 0.8 mg/ kg (up to a maximum of 50 mg per dose) once weekly.
Odmerek naj bo 0, 8 mg/ kg (do največ 50 mg na odmerek) enkrat na teden.
Renal and hepatic impairment
Bolniki z jetrno ali ledvično okvaro
Sepsis or risk of sepsis.
Sepsa ali možnost nastanka sepse.
Serious infections, sepsis, tuberculosis, and opportunistic infections, including invasive fungal infections, have been reported with the use of Enbrel (see section 4.8).
Poročali so o primerih resnih okužb, sepse, tuberkuloze in oportunističnih okužb, vključno z invazivnimi glivičnimi okužbami, pri uporabi zdravila Enbrel (glejte poglavje 4. 8).
These infections were due to bacteria, mycobacteria, fungi and viruses.
Te okužbe so povzročale bakterije, mikobakterije, glivice in virusi.
In some cases, particular fungal and other opportunistic infections have not been recognised, resulting in delay of appropriate treatment and sometimes death.
Včasih določenih glivičnih in drugih oportunističnih okužb niso prepoznali, zaradi česar je prišlo do zakasnitve ustreznega zdravljenja in včasih bolnikove smrti.
In evaluating patients for infections, the patient ’ s risk for relevant opportunistic infections (e. g., exposure to endemic mycoses) should be considered.
Pri pregledovanju bolnikov glede okužb moramo upoštevati bolnikovo tveganje za relevantne oportunistične okužbe (npr. izpostavljenost endemičnim mikozam).
Patients who develop a new infection while undergoing treatment with Enbrel should be monitored closely.
Bolnike, pri katerih se med zdravljenjem z zdravilom Enbrel pojavi nova okužba, je treba strogo nadzorovati.
Administration of Enbrel should be discontinued if a patient develops a serious infection.
Zdravljenje z zdravilom Enbrel je treba prekiniti, če pride do hude okužbe.
Physicians should exercise caution when considering the use of Enbrel in patients with a history of recurring or chronic infections or with underlying conditions that may predispose patients to infections such as advanced or poorly controlled diabetes.
Zdravniki morajo biti zelo previdni, ko se odločajo za zdravljenje s tem zdravilom pri bolnikih s ponavljajočimi se ali kroničnimi okužbami v anamnezi ali z drugimi osnovnimi stanji, kot je na primer napredovala ali neurejena sladkorna bolezen, ki bi lahko povečala dovzetnost bolnika za okužbe.
Tuberculosis
4 Tuberkuloza
Cases of active tuberculosis including miliary tuberculosis and tuberculosis with extra-pulmonary location have been reported in patients treated with Enbrel.
Pri bolnikih, zdravljenih z zdravilom Enbrel, so poročali o primerih aktivne tuberkuloze, vključno z miliarno tuberkulozo in zunajpljučno tuberkulozo.
Before starting treatment with Enbrel, all patients must be evaluated for both active and inactive (‘ latent’) tuberculosis.
Pred začetkom zdravljenja z zdravilom Enbrel je treba vse bolnike pregledati tako glede aktivne kot glede neaktivne ('latentne') tuberkuloze.
This evaluation should include a detailed medical history with personal history of tuberculosis or possible previous contact with tuberculosis and previous and/ or current immunosuppressive therapy.
Ta pregled mora zajeti natančno medicinsko anamnezo z osebno anamnezo tuberkuloze ali možnim predhodnim stikom s tuberkulozo in predhodnim in/ ali sedanjim imunosupresivnim zdravljenjem.
Appropriate screening tests, i. e. tuberculin skin test and chest x-ray, should be performed in all patients (local recommendations may apply).
Pri vseh bolnikih je treba opraviti ustrezne presejalne teste, t. j. tuberkulinski kožni test in rentgensko slikanje pljuč in srca (morda obstajajo lokalna priporočila glede teh preiskav).
It is recommended that the conduct of these tests should be recorded in the patient ’ s alert card.
Priporočljivo je, da se ti testi vpišejo v bolnikovo opozorilno kartico.
Prescribers are reminded of the risk of false negative tuberculin skin test results, especially in patients who are severely ill or immunocompromised.
Zdravnike, ki predpisujejo zdravilo, opominjamo na nevarnost lažnih negativnih rezultatov tuberkulinskega kožnega testa, posebno pri bolnikih, ki so težko bolni ali imunokompromitirani.
If active tuberculosis is diagnosed, Enbrel therapy must not be initiated.
Če se postavi diagnoza aktivne tuberkuloze, ni dovoljeno uvesti zdravljenja z zdravilom Enbrel.
If inactive (‘ latent’) tuberculosis is diagnosed, treatment for latent tuberculosis must be started with anti-tuberculosis therapy before the initiation of Enbrel, and in accordance with local recommendations.
Če se ugotovi neaktivna ('latentna') tuberkuloza, se mora pred uvedbo zdravila Enbrel in v skladu z lokalnimi priporočili začeti zdravljenje latentne tuberkuloze s tuberkulostatiki.
In this situation, the benefit/ risk balance of Enbrel therapy should be very carefully considered.
V takem primeru je treba zelo skrbno pretehtati razmerje tveganja in koristi zdravljenja z zdravilom Enbrel.
All patients should be informed to seek medical advice if signs/ symptoms suggestive of tuberculosis (e. g., persistent cough, wasting/ weight loss, low-grade fever) appear during or after Enbrel treatment.
Vsem bolnikom je treba naročiti, naj poiščejo zdravniško pomoč, če se med zdravljenjem z zdravilom Enbrel ali po njem pojavijo znaki/ simptomi, ki kažejo na tuberkulozo (npr. trdovraten kašelj, hiranje/ hujšanje, nekoliko zvišana telesna temperatura).
Reactivation of hepatitis B virus (HBV) in patients who are chronic carriers of this virus who are receiving TNF-antagonists including Enbrel has been reported.
Poročali so o reaktivaciji virusa hepatitisa B (HBV) pri bolnikih, ki so kronični prenašalci tega virusa in ki so prejemali antagoniste TNF, med drugim tudi zdravilo Enbrel.
Patients at risk for HBV infection should be evaluated for prior evidence of HBV infection before initiating Enbrel therapy.
Bolnike, ki jih ogroža nevarnost okužbe s HBV, je treba pred uvedbo zdravljenja z zdravilom Enbrel pregledati glede predhodnih znakov okužbe s HBV.
Caution should be exercised when administering Enbrel to patients identified as carriers of HBV.
Pri dajanju zdravila Enbrel bolnikom, za katere vemo, da so prenašalci HBV, je potrebna previdnost.
If Enbrel is used in carriers of HBV, the patients should be monitored for signs and symptoms of active HBV infection and, if necessary, appropriate treatment should be initiated.
Če uporabljamo zdravilo Enbrel pri prenašalcih HBV, moramo bolnike spremljati glede znakov in simptomov aktivne okužbe s HBV, po potrebi pa moramo začeti z ustreznim zdravljenjem.
5 Worsening of hepatitis C
Poslabšanje hepatitisa C
Concurrent Enbrel and anakinra treatment
Sočasno zdravljenje z zdravilom Enbrel in anakinro
This combination has not demonstrated increased clinical benefit.
Ta kombinacija ni pokazala povečane klinične koristi.
Thus the combined use of Enbrel and anakinra is not recommended (see sections 4.5 and 4.8).
Uporaba zdravila Enbrel skupaj z anakinro ni priporočljiva (glejte poglavji 4. 5 in 4. 8).
Concurrent Enbrel and abatacept treatment
Sočasno zdravljenje z zdravilom Enbrel in abataceptom
This combination has not demonstrated increased clinical benefit; such use is not recommended (see section 4.5).
Za to kombinacijo zvečana klinična koristnost ni dokazana, zato njena uporaba ni priporočljiva (glejte poglavje 4. 5).
The needle cover of the pre-filled syringe contains latex (dry natural rubber) that may cause hypersensitivity reactions when handled by or when Enbrel is administered to persons with known or possible latex sensitivity.
Pokrovček igle napolnjenih injekcijskih brizg vsebuje lateks (posušen naravni kavčuk), ki lahko povzroči preobčutljivostne reakcije, če z zdravilom ravna oseba z znano ali možno preobčutljivostjo za lateks ali če ga damo takšni osebi.
Allergic reactions associated with Enbrel administration have been reported commonly.
5 V povezavi z uporabo zdravila Enbrel so pogosto poročali o alergijskih reakcijah.
If any serious allergic or anaphylactic reaction occurs, Enbrel therapy should be discontinued immediately and appropriate therapy initiated.
Če se pojavi kakršna koli resna alergijska ali anafilaktična reakcija, je potrebno terapijo s tem zdravilom takoj prekiniti in uvesti ustrezno zdravljenje.
In a study of 49 adult patients with rheumatoid arthritis treated with Enbrel, there was no evidence of depression of delayed-type hypersensitivity, depression of immunoglobulin levels, or change in enumeration of effector cell populations.
Študija pri 49 odraslih bolnikih z revmatoidnim artritisom ni pokazala, da bi zdravljenje z zdravilom Enbrel zmanjšalo pozno preobčutljivostno reakcijo, zmanjšalo nivo imunoglobulinov ali spremenilo število efektorskih celic.
Two juvenile idiopathic arthritis patients developed varicella infection and signs and symptoms of aseptic meningitis, which resolved without sequelae.
Pri dveh bolnikih z juvenilnim idiopatskim artritisom so se razvili okužba z noricami in znaki in simptomi aseptičnega meningitisa, ki so izzveneli brez posledic.
Patients with a significant exposure to varicella virus should temporarily discontinue Enbrel therapy and be considered for prophylactic treatment with Varicella Zoster Immune Globulin.
Bolniki, ki so zelo izpostavljeni virusu noric, naj začasno prekinejo zdravljenje z zdravilom Enbrel, pridejo pa tudi v poštev za profilaktično zdravljenje z imunoglobulinom proti virusu varicela- zoster.
The safety and efficacy of Enbrel in patients with immunosuppression or chronic infections have not been evaluated.
Varnosti in učinkovitosti zdravila Enbrel pri bolnikih z imunosupresijo ali kroničnimi okužbami niso ovrednotili.
Reports of various malignancies (including breast and lung carcinoma and lymphoma) have been received in the postmarketing period (see section 4.8).
V obdobju po prihodu zdravila na trg je bilo več poročil o raznih malignih boleznih (vključno s karcinomom dojke in pljuč in limfomi) (glejte poglavje 4. 8).
However, the
V nadzorovanih delih kliničnih preskušanj z zaviralci TNF so pri bolnikih, ki so prejemali zaviralec TNF, opazili več primerov limfomov kot pri kontrolni skupini bolnikov.
6 occurrence was rare, and the follow-up period of placebo patients was shorter than for patients receiving TNF-antagonist therapy.
Pojavnost je bila sicer redka, obdobje spremljanja bolnikov, ki so prejemali placebo pa krajše kot pri bolnikih, ki so prejemali zaviralec TNF.
Furthermore, there is an increased background lymphoma risk in rheumatoid arthritis patients with long-standing, highly active, inflammatory disease, which complicates the risk estimation.
Poleg tega je pri bolnikih, ki imajo revmatoidni artritis z dolgotrajno in zelo aktivno vnetno boleznijo, osnovno tveganje za pojav limfomov povečano, kar oteži oceno tveganja.
With the current knowledge, a possible risk for the development of lymphomas or other malignancies in patients treated with a TNF-antagonist cannot be excluded.
Na podlagi sedanjih dognanj pri bolnikih, ki se zdravijo z zaviralcem TNF možnega tveganja za razvoj limfomov ali drugih rakavih obolenj ni možno izključiti.
It is recommended that juvenile idiopathic arthritis patients, if possible, be brought up to date with all immunisations in agreement with current immunisation guidelines prior to initiating Enbrel therapy.
Za bolnike z juvenilnim idiopatskim artritisom priporočamo, da pred začetkom zdravljenja z zdravilom Enbrel, če je le mogoče, opravijo vsa cepljenja v skladu z veljavnimi smernicami za cepljenje.
In a double blind, placebo controlled, randomised clinical study in adult patients with psoriatic arthritis 184 patients also received a multivalent pneumococcal polysaccharide vaccine at week 4.
V dvojno slepi, s placebom kontrolirani, randomizirani klinični raziskavi pri odraslih bolnikih s psoriatičnim artritisom je 184 bolnikov v 4. tednu dobilo tudi multivalentno polisaharidno cepivo proti pnevmokokom.
In this study most psoriatic arthritis patients receiving Enbrel were able to mount effective B-cell immune response to pneumococcal polysaccharide vaccine, but titers in aggregate were moderately lower and few patients had two-fold rises in titers compared to patients not receiving Enbrel.
Toda celokupno so bili titri zmerno nižji in nekaj bolnikov je doživelo dvakraten porast titrov v primerjavi z bolniki, ki niso dobivali zdravila Enbrel.
Treatment with Enbrel may result in the formation of autoimmune antibodies (see section 4.8).
Zdravljenje z zdravilom Enbrel lahko sproži nastajanje avtoimunskih protiteles (glejte poglavje 4. 8).
Caution should be exercised in patients being treated with Enbrel who have a previous history of blood dyscrasias.
Vse bolnike in starše/ skrbnike je treba opozoriti, da morajo pri bolniku v primeru pojava znakov ali simptomov, ki
All patients and parents/ caregivers should be advised that if the patient develops signs and symptoms suggestive of blood dyscrasias or infections (e. g. persistent fever, sore throat, bruising, bleeding, paleness) whilst on Enbrel, they should seek immediate medical advice.
6 kažejo na krvno diskrazijo ali okužbo (npr. trdovratna zvišana telesna temperatura, vnetje žrela, podplutbe, krvavitve, bledica), med zdravljenjem s tem zdravilom takoj poiskati zdravniško pomoč.
Such patients should be investigated urgently, including full blood count; if blood dyscrasias are confirmed, Enbrel should be discontinued.
Take bolnike je potrebno takoj pregledati, vključno s pregledom celotne krvne slike, in v primeru krvne diskrazije prekiniti zdravljenje s tem zdravilom.
CNS disorders
Motnje CŽS
There have been rare reports of CNS demyelinating disorders in patients treated with Enbrel (see section 4.8).
Poročali so o redkih primerih demielinizirajočih obolenj centralnega živčnega sistema (CŽS) pri bolnikih, zdravljenih s tem zdravilom (glejte poglavje 4. 8).
Although no clinical trials have been performed evaluating Enbrel therapy in patients with multiple sclerosis, clinical trials of other TNF antagonists in patients with multiple sclerosis have shown increases in disease activity.
Čeprav ni bilo kliničnih raziskav za ovrednotenje terapije z zdravilom Enbrel pri bolnikih z multiplo sklerozo, so klinične raziskave drugih zaviralcev TNF pri teh bolnikih pokazale poslabšanje bolezni.
A careful risk/ benefit evaluation, including a neurologic assessment, is recommended when prescribing Enbrel to patients with pre-existing or recent onset of CNS demyelinating disease, or to those who are considered to have an increased risk of developing demyelinating disease.
Pri bolnikih z demielinizirajočimi obolenji CŽS, ki so obstajala že prej ali so se pojavila pred kratkim ali pri tistih, ki imajo povečano tveganje za razvoj demielinizirajoče bolezni, je potrebno pred zdravljenjem z zdravilom Enbrel skrbno pretehtati tveganja in koristi, vključno z nevrološko oceno.