Etanercept is a dimeric fusion protein consisting of the extracellular ligand-binding portion of the tumor necrosis factor receptor (TNFR) linked to a human IgG1. The receptor binds to TNF, it is not a monoclonal antibody. It is licensed for juvenile rheumatoid arthritis and juvenile idiopathic arthritis. Side effects are septic arthritis, demyelination, pancytopenia, aplastic anaemia and congestive heart failure. .