Biologics like Amgen's Enbrel--a protein drug for immune diseases including rheumatoid arthritis and psoriasis--have become blockbusters.
Other medicines, including multiple myeloma drug Velcade, from Millennium, and rheumatoid arthritis medicine Enbrel, from Amgen.
Until now, one of the biggest problems with Enbrel was making enough of it.
The drug works differently from Enbrel but is not seen as any more effective.
Amgen books most of the sales of Enbrel within the U.S., but Wyeth sells it internationally.
Enbrel, concocted in 1989, targets the prototype member of this gene family: tumor necrosis factor.
Pfizer is currently developing a pill, tofacitinib, that will compete with Enbrel in the rheumatoid arthritis market.
In fact, most analysts think Enbrel, the leader in the rheumatoid-arthritis space, will also lead in psoriasis.
After hearing about Enbrel, Dr. Mann called Immunex in 1994 and proposed testing it in heart failure patients.
Protein drugs like Enbrel are much more expensive to make than traditional small-molecule drugs, and Thousand Oaks, Calif.
Enbrel works by blocking a long-mysterious protein in the immune system known as tumor necrosis factor, or TNF.
Amgen's Enbrel has a long safety record, seems very effective, and can be injected by patients at home.
Immunex is now sponsoring preliminary human tests to see if Enbrel can help in leukemia, lung and ovarian tumors.
Or simply giving, say, their Tamiflu to a sick neighbor or their Enbrel to a 59-year-old friend with arthritis.
"Enbrel is going to be very important going forward internationally, " says Bernard Poussot , Wyeth's head of pharmaceuticals.
The guy heading this up for the company, Leroux Jooste, is the same guy who brought Enbrel to market.
But Kineret may actually benefit from being sold side by side with Enbrel.
Immunex had badly underestimated demand for Enbrel, its breakthrough drug for rheumatoid arthritis.
Analysts are watching closely to see whether Enbrel, a similar drug, also falls short when its maker, Thousand Oaks, Calif.
What made Amgen Chief Executive Kevin Sharer , a former nuclear submarine officer and telecommunications executive, so interested in Enbrel?
Peter A. Ubel is an internist who says he would start an arthritis patient on inexpensive methotrexate before escalating to Enbrel.
What if Kineret and Enbrel work better when given at the same time, as a combination therapy, than either does alone?
Enbrel is now in tests for two dozen other diseases, from chronic heart failure to psoriasis to Alzheimer's and even some cancers.
The most promising frontier for Enbrel is in treating chronic heart failure.
In a test of Enbrel on 19 psoriasis patients, on average half of the rash disappeared after three months, with few side effects.
Amgen also sells Enbrel, a treatment for rheumatoid arthritis and psoriasis, and it has a handful of promising new drugs in its pipeline.
Remicade acts through a mechanism similar to Enbrel, a drug made by Immunex (nasdaq: IMNX - news - people ).
Analysts also have deep disagreements over tofacitinib, a pill for rheumatoid arthritis that is seen as likely to displace injectable medicines like Enbrel.
After a bumpy road through human trials--Enbrel flopped as a sepsis remedy before Immunex found the arthritis application--it won approval in late 1998.
Injected into the arm or leg, Enbrel travels through the body, binding to free TNF molecules to prevent them from docking with the real receptors.
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