Is Enbrel better than Bimzelx? A Clinical Showdown

October 7, 2025 •

4 min read

Affecting millions worldwide, moderate to severe plaque psoriasis requires effective treatment options [1.7.3]. In the debate of biologic medications, a key question for patients and clinicians is: Is Enbrel better than Bimzelx? This article examines the data behind these two prominent drugs.

Quick Summary

Bimzelx, a dual IL-17A and IL-17F inhibitor, often shows higher efficacy rates for skin clearance in psoriasis than Enbrel, a TNF inhibitor [1.3.5, 1.4.1, 1.4.6]. The choice depends on the specific condition, patient history, and safety profile.

Key Points

Different Mechanisms: Bimzelx is a dual IL-17A/F inhibitor, while Enbrel is a TNF inhibitor, targeting different inflammatory pathways [1.4.1, 1.4.6].
Superior Skin Clearance: Clinical data suggests Bimzelx achieves higher rates of complete and near-complete skin clearance (PASI 90/100) in psoriasis patients compared to other biologics [1.3.5].
Psoriatic Arthritis Efficacy: Bimzelx shows favorable efficacy for joint and skin symptoms in psoriatic arthritis, ranking highly in meta-analyses [1.3.4, 1.3.6].
Safety Profiles Differ: Enbrel is commonly associated with injection site reactions, while Bimzelx has a higher incidence of oral candidiasis (thrush) [1.5.2, 1.9.4].
Long-Term Data: Enbrel has a much longer history of use and real-world safety data compared to the more recently approved Bimzelx [1.7.3, 1.8.5].
Treatment History Matters: Bimzelx has shown strong efficacy in patients who have previously been treated with TNF inhibitors [1.3.6].
Patient-Specific Choice: The 'better' medication depends on the specific diagnosis, disease severity, previous treatments, and a discussion of risks with a doctor.

Introduction to Enbrel and Bimzelx

Enbrel (etanercept) and Bimzelx (bimekizumab) are injectable biologic drugs used to treat several autoimmune inflammatory diseases, but they work through different mechanisms [1.4.1, 1.4.6]. Enbrel, a Tumor Necrosis Factor (TNF) inhibitor, has been a cornerstone treatment for conditions like rheumatoid arthritis, psoriatic arthritis (PsA), and plaque psoriasis (PsO) for many years [1.7.1, 1.7.3]. It works by binding to and inhibiting TNF, a cytokine that promotes inflammation [1.4.6].

Bimzelx is a newer medication that represents a different class of biologic. It is a dual inhibitor that selectively targets both Interleukin-17A (IL-17A) and Interleukin-17F (IL-17F), two key cytokines that drive inflammation in a number of autoimmune conditions [1.4.1, 1.4.5]. The FDA approved Bimzelx for moderate-to-severe plaque psoriasis in October 2023 and expanded its indications to include psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis in 2024 [1.8.1, 1.8.5].

Mechanism of Action: A Tale of Two Pathways

The fundamental difference between Enbrel and Bimzelx lies in what they target.

Enbrel (Etanercept)

Enbrel functions as a TNF inhibitor. In autoimmune diseases, the body produces excess TNF, leading to chronic inflammation and tissue damage. Enbrel acts like a sponge, binding to TNF molecules and rendering them inactive before they can trigger the inflammatory cascade [1.4.6]. This has proven effective in managing symptoms across a range of conditions for over two decades [1.7.3].

Bimzelx (Bimekizumab)

Bimzelx offers a more targeted approach by neutralizing both IL-17A and IL-17F. Research has shown that both of these interleukins are critical drivers of the inflammation seen in psoriasis and psoriatic arthritis [1.4.1]. By inhibiting both, Bimzelx provides a more comprehensive suppression of this specific inflammatory pathway compared to drugs that only target IL-17A [1.4.5]. This dual inhibition is believed to be a key reason for its high efficacy, particularly in achieving skin clearance [1.4.3].

Efficacy in Clinical Trials

While direct head-to-head trials comparing Bimzelx and Enbrel are not as common as trials against other biologics like Humira or ustekinumab, network meta-analyses and data from individual trials provide a clear picture of their relative effectiveness.

For plaque psoriasis, studies consistently show Bimzelx achieving very high levels of skin clearance. A network meta-analysis found that at 10–16 weeks, bimekizumab had the highest probability of achieving PASI 90 (84.0%) and PASI 100 (57.8%)—measures of near-complete and complete skin clearance, respectively—demonstrating statistical superiority over other biologics [1.3.5].

For psoriatic arthritis, network meta-analyses suggest that bimekizumab ranks favorably among all approved treatments for joint, skin, and minimal disease activity outcomes [1.3.4, 1.3.6]. In one analysis, for patients who had previously taken a TNF inhibitor (like Enbrel), bimekizumab ranked first, second, and first for achieving ACR20/50/70 responses, respectively, which measure joint improvement [1.3.6].

Comparative Overview


Feature	Enbrel (etanercept)	Bimzelx (bimekizumab)
Drug Class	TNF inhibitor [1.4.6]	Dual IL-17A and IL-17F inhibitor [1.4.1]
Mechanism	Binds to and neutralizes Tumor Necrosis Factor (TNF) [1.4.6].	Selectively binds to and neutralizes IL-17A and IL-17F [1.4.5].
Approved Uses	Plaque Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Ankylosing Spondylitis, Juvenile Idiopathic Arthritis [1.7.1, 1.7.5].	Plaque Psoriasis, Psoriatic Arthritis, Ankylosing Spondylitis, Non-radiographic Axial Spondyloarthritis, Hidradenitis Suppurativa [1.8.3, 1.8.5].
Administration	Subcutaneous injection, typically 50 mg once weekly (initial PsO dose may be twice weekly) [1.6.4, 1.7.3].	Subcutaneous injection. Dosing varies by condition, e.g., 320 mg at weeks 0, 4, 8, 12, 16, then every 8 weeks for PsO [1.6.1, 1.6.5].
Key Side Effect	Injection site reactions, upper respiratory infections [1.9.4].	Upper respiratory infections, oral candidiasis (thrush), headache [1.5.2, 1.5.3].

Safety and Side Effects

Both medications suppress parts of the immune system and thus carry an increased risk of infections.

Enbrel's most common side effects include injection site reactions and upper respiratory infections [1.9.4]. As a TNF inhibitor, its label includes warnings about serious infections and certain types of cancer.

Bimzelx is most commonly associated with upper respiratory tract infections and headaches [1.5.3]. A notable side effect linked to IL-17 inhibition is an increased risk of oral candidiasis (thrush), which is reported more frequently with Bimzelx than with TNF inhibitors [1.5.2, 1.5.4]. Both drugs require screening for tuberculosis (TB) before starting treatment [1.6.3].

Conclusion: Which is Better?

Deciding if Enbrel is better than Bimzelx depends heavily on the individual patient's condition, treatment history, and priorities.

Based on clinical data, Bimzelx appears to offer superior efficacy in achieving high levels of skin clearance (PASI 90/100) for plaque psoriasis compared to many other biologics, including what would be expected from TNF inhibitors like Enbrel [1.3.5]. Its dual-inhibition mechanism may provide a more powerful and targeted effect on the specific inflammatory pathways of psoriasis [1.4.5].

However, Enbrel has a much longer track record of safety and efficacy, having been used for over two decades [1.7.3]. For some patients, particularly those with conditions like rheumatoid arthritis or those for whom TNF inhibition is a proven mechanism, Enbrel remains an excellent and reliable choice. The risk-benefit calculation, considering Bimzelx's higher rates of oral candidiasis versus Enbrel's known profile, is a critical conversation to have with a healthcare provider. Ultimately, the 'better' drug is the one that provides the best outcome with the most manageable side effect profile for the individual.

For more detailed clinical trial information, you can visit the U.S. National Library of Medicine's database at clinicaltrials.gov.

Frequently Asked Questions

Both are used for moderate-to-severe plaque psoriasis and psoriatic arthritis. Enbrel is also approved for rheumatoid arthritis and juvenile idiopathic arthritis, while Bimzelx is also approved for ankylosing spondylitis, non-radiographic axial spondyloarthritis, and hidradenitis suppurativa [1.7.5, 1.8.3].

Bimzelx blocks two specific inflammatory proteins, IL-17A and IL-17F [1.4.1]. Enbrel blocks a different protein called Tumor Necrosis Factor (TNF) [1.4.6]. They target different parts of the immune response that cause inflammation.

Clinical studies and meta-analyses indicate that Bimzelx has a higher probability of achieving PASI 90 and PASI 100, which represent near-total and total skin clearance, compared to many other biologics [1.3.5].

Both are given as subcutaneous (under the skin) injections. The dosing schedule varies; Enbrel is often once weekly, while Bimzelx has an initial loading phase followed by injections every 4 to 8 weeks, depending on the condition [1.6.4, 1.6.5].

The most common side effects of Bimzelx are upper respiratory tract infections, headache, and oral candidiasis (thrush) [1.5.2, 1.5.3].

Common side effects for Enbrel include upper respiratory infections and reactions at the injection site, such as redness, swelling, or pain [1.9.4].

Yes, switching between biologic medications is common. Studies have shown that Bimzelx is effective in patients who have previously been treated with a TNF inhibitor like Enbrel [1.3.6]. This decision must be made with your healthcare provider.