Review Article

Rheumatology International

, Volume 35, Issue 2, pp 197-209

Open Access This content is freely available online to anyone, anywhere at any time.

Etanercept biosimilars

  • Valderilio F. AzevedoAffiliated withInternal Medicine, Universidade Federal do ParanáRheumatology Service, Hospital de Clínicas de CuritibaDepartment of Clinical Trial, Edumed-Health Biotechnology Email author 
  • , Nathalia GalliAffiliated withInternal Medicine, Universidade Federal do Paraná
  • , Alais KleinfelderAffiliated withInternal Medicine, Universidade Federal do Paraná
  • , Julia D’IppolitoAffiliated withInternal Medicine, Universidade Federal do Paraná
  • , Paulo C. M. UrbanoAffiliated withDepartment of Clinical Trial, Edumed-Health Biotechnology


Etanercept was the first tumour necrosis factor alpha antagonist approved in the USA for the treatment of rheumatoid arthritis, in 1998, and then for other diseases. With the etanercept patent set to expire in the EU in 2015, a number of etanercept copies have reached the production phase and are undergoing clinical trials, with the promise of being cheaper alternatives to the reference product. In a global scenario that is favourable to the entry of biosimilars, this article discusses the stage of development, manufacture, clinical trials and the regulatory process involved in the approval of etanercept biosimilars, compiling the literature data. Reducing treatment cost is the principal attraction for biosimilars to emerge in the global market. It is essential for the doctors’ decision on the prescription of these medications, as well as for payers, to have clearly defined studies of clinical equivalence, quality, and safety in order to better evaluate the various copies of etanercept. The authors discuss the need to harmonize different national regulations and the introduction of effective pharmacosurveillance systems for prompt recognition of adverse effects in copies of biopharmaceuticals that differ from those found in the reference products.


Etanercept Biosimilars TNF-α Rheumatoid arthritis Spondyloarthritis Comparability