Active RA, alone or in combination w/ MTX, in adults w/ inadequate response to DMARDs; severe, active & progressive RA in adult - not previously treated w/ MTX; active polyarticular-course juvenile chronic arthritis in childn 4-17 yr who have had an inadequate response to, or who have proved intolerant of MTX; active & progressive psoriatic arthritis, severe active ankylosing spondyilitis in adults when the response to previous DMARD therapy has been inadequate; adults (≥18 yr) w/ 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, MTX or PUVA.
Adult 18-64 yrRA 25 mg twice wkly. Alternatively, 50 mg once wkly. Psoriatic arthritis & ankylosing spondyilitis 25 mg SC twice wkly, alternatively, 50 mg once wkly. Plaque psoriasis 25 mg SC twice wkly, alternatively, 50 mg twice wkly may be used up to 12 wk followed, if necessary, by dose 25 mg twice wkly. Treatment should continue until remission is achieved for up to 24 wk. Discontinue in patients who show no response after 12 wk. Elderly ≥65 yr Same as for adults 18-64 yr. Childn & adolescent (≥4 to <18 yr) 0.4 mg/kg SC (up to max of 25 mg/dose) twice wkly w/ interval 3-4 days between doses.
History of recurring or chronic infections or w/ underlying conditions which may predispose patients to infections eg, advanced or poorly controlled diabetes. Concurrent Enbrel & anakinra treatment. Wegener's granulomatosis. Alcoholic hepatitis. Allergic reactions. Immunosuppression. Malignancies & lymphoproliferative disorders. Skin cancer. Live vaccines should not be given concurrently. Autoantibody formation. Haematologic reactions. Neurological disorders. Combination therapy. CHF. TB. Hepatitis B reactivation. Worsening of hepatitis C. Hypoglycemia in patients treated for diabetes. Inflammatory bowel disease (IBD) in patients w/ juvenile idiopathic arthritis (JIA). Renal & hepatic impairment. Pregnancy & lactation. Childn <4 yr.
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