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Cosentyx vs Humira
Introduction
For patients with autoimmune diseases such as psoriasis, rheumatoid arthritis, or ankylosing spondylitis, certain drugs can help manage symptoms by targeting specific proteins in the body that contribute to inflammation. Cosentyx and Humira are two such medications often prescribed for these conditions. They each target different proteins in the body but both have anti-inflammatory effects on patients with autoimmune disorders.
Cosentyx is a human interleukin-17A (IL-17A) antagonist that blocks the action of IL-17A, a protein involved in immune responses and inflammation. On the other hand, Humira is classified as a tumor necrosis factor-alpha (TNFα) inhibitor which primarily blocks TNF alpha's action - another protein involved in systemic inflammation.
What is Cosentyx?
Secukinumab (the generic name for Cosentyx) is a human monoclonal antibody that works by blocking the activity of Interleukin-17A, a protein in the body that causes inflammation. It was first approved by the FDA in 2015 and marked a significant progression from older classes of drugs used to treat autoimmune diseases like psoriasis, such as tumor necrosis factor inhibitors (TNFIs). Humira belongs to this older class of TNFIs. Secukinumab treats plaque psoriasis, ankylosing spondylitis, and psoriatic arthritis by binding to IL-17A and inhibiting its interaction with the IL-17 receptor thus reducing inflammation. Comparatively speaking, secukinumab has more specificity than adalimumab (Humira), which results in fewer side effects overall because it does not impact other inflammatory pathways influenced by TNF inhibition.
What conditions is Cosentyx approved to treat?
Cosentyx is approved for the treatment of several autoimmune diseases:
- Moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
- Active psoriatic arthritis in adult patients
- Active ankylosing spondylitis in adult patients
- Active non-radiographic axial spondyloarthritis with objective signs of inflammation as evidenced by elevated C-reactive protein (CRP) and/or magnetic resonance imaging (MRI) evidence
How does Cosentyx help with these illnesses?
Cosentyx helps to manage symptoms of psoriasis, psoriatic arthritis and ankylosing spondylitis by inhibiting the action of interleukin-17A (IL-17A), a protein that contributes to inflammation. It does this by binding directly to IL-17A, preventing it from interacting with its receptor on the surface of cells. Interleukin-17A is a cytokine, a type of small protein that plays crucial roles in cell signaling and immune responses. Overproduction or unregulated activity of IL-17A has been associated with several inflammatory conditions including psoriatic diseases. Therefore, by limiting IL-17A actions, Cosentyx can reduce inflammation and help patients manage their condition.
What is Humira?
Humira, also known by its generic name adalimumab, is a type of drug called a TNF-alpha inhibitor. This means that it works to reduce the action of tumor necrosis factor alpha (TNF-alpha), a substance in the body which can cause inflammation and lead to immune-system diseases. Humira was first approved by the FDA in 2002.
Unlike Cosentyx, which specifically targets an immune system protein called interleukin-17A (IL-17A), Humira has broader effects on the immune system because of its action against TNF-alpha. This makes it potentially more effective for patients who have not responded well to other treatments.
In terms of side-effects, while both drugs carry potential risks such as serious infections or cancer due to their effect on the immune system, Humira does not typically cause symptoms like diarrhea or upper respiratory tract infections often seen with Cosentyx. However, this wider range of impact on your body's defenses could make you more susceptible overall to different types of illnesses.
What conditions is Humira approved to treat?
Humira has been approved by the FDA for use in several different conditions, including:
- Rheumatoid arthritis
- Psoriatic arthritis
- Ankylosing spondylitis
- Crohn's disease and ulcerative colitis
- Plaque psoriasis
How does Humira help with these illnesses?
Tumor necrosis factor-alpha (TNF-α) is a cytokine involved in systemic inflammation, playing a critical role in the body's immune response to infection. However, overproduction of TNF-α has been implicated in autoimmune diseases such as rheumatoid arthritis and psoriasis. Humira functions by binding to TNF-α, thus inhibiting its interaction with cell surface receptors and reducing inflammatory responses. Although it operates on the same biological pathway as Cosentyx, Humira targets a different molecule within that pathway. This makes it an effective treatment option for patients who do not respond well to interleukin inhibitors like Cosentyx or may be used in combination therapy depending on patient needs.
How effective are both Cosentyx and Humira?
Both secukinumab (Cosentyx) and adalimumab (Humira) have proven track records for treating autoimmune conditions like psoriasis, rheumatoid arthritis, and ankylosing spondylitis. They were approved by the FDA in 2015 and 2002 respectively, with each acting on different inflammatory pathways which may dictate their prescription under varying circumstances. Direct comparisons of secukinumab and adalimumab's effectiveness in managing moderate to severe plaque psoriasis were carried out in a double-blind clinical trial in 2015; both drugs exhibited similar efficacy rates as well as promising safety profiles.
A review of meta-analysis reports on secukinumab showed it is effective at alleviating symptoms from the first dose onwards. Its side effect profile is found to be favorable compared to other biologics used for similar indications, being generally well-tolerated even among patients with comorbidities or those who are elderly. The study also reported that Secukinumab has become increasingly prescribed due its unique mechanism targeting IL-17A directly rather than TNF-alpha inhibitors like Adalimumab.
Conversely, a systematic review conducted in 2020 indicated that adalimumab seems more effective than placebo across multiple autoimmune diseases including Crohn’s disease where Cosentyx doesn’t have an indication yet. However, Humira carries a black box warning related to serious infections potentially leading to hospitalization or death if not managed promptly which makes physicians opt for Cosentyx when manageable side effects are particularly crucial.
At what dose is Cosentyx typically prescribed?
Dosages of Cosentyx usually start at 300 mg at the beginning of treatment for psoriasis, psoriatic arthritis and ankylosing spondylitis. This is typically administered as five subcutaneous injections of 60mg each. After that, a maintenance dosage of 300 mg (delivered as one injection) every four weeks is recommended. For Humira, the typical starting dose for rheumatoid arthritis patients is 40 mg injected subcutaneously every other week. Some people may need a higher dose of Humira for more severe conditions; these dosages will be determined by your healthcare provider based on your specific needs and condition. Children's doses are calculated according to body weight and disease severity.
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At what dose is Humira typically prescribed?
Humira treatment is typically initiated with a loading dose of 160 mg (four 40 mg injections in one day or two 40 mg injections per day for two consecutive days) for conditions like rheumatoid arthritis or psoriatic arthritis. Subsequent dosing is usually 40 mg every other week, starting one week after the initial dose. For more severe cases like Crohn's disease, the dosage might be increased to every week administration if there is no response observed at bi-weekly doses after a few weeks. The timing and amount of Humira can vary depending on your specific condition and overall health status; therefore, it should always be taken under the supervision of a healthcare professional.
What are the most common side effects for Cosentyx?
Common side effects experienced by patients taking Cosentyx may include:
- Diarrhea
- Upper respiratory infections (such as colds)
- Runny or stuffy nose, and nasal polyps
- Itchy, red eyes or pink eye (conjunctivitis)
- Fever, muscle aches, and other flu-like symptoms
- Nausea
On the other hand, common side effects for those taking Humira might include:
- Skin rash at the site of injection
- Headaches
- Nausea and stomach pain
- Cold symptoms such as sneezing and sore throat -Fatigue or feeling tired
It's important to note that both medications can potentially cause more serious side effects. If these symptoms occur while on either medication you should seek immediate medical attention.
Are there any potential serious side effects for Cosentyx?
Cosentyx and Humira, both used to treat conditions like psoriasis and rheumatoid arthritis, can have serious side effects in rare cases. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing or swallowing; swelling of your face, lips, tongue, or throat
- New or worsening symptoms of neurologic disease (multiple sclerosis), including numbness or weakness on one side of your body, problems with vision or muscle movement
- Symptoms associated with heart failure such as shortness of breath (even while lying down), feeling tired easily, rapid weight gain from fluid retention
- Signs indicating low levels of white blood cells leading to infections - feverish chills that don't go away, sore throat that doesn't heal
- Serious liver problems: upper stomach pain that radiates towards the back region along with nausea and vomiting.
If you experience any unusual symptoms after taking either Cosentyx or Humira it is crucial you seek medical attention immediately.
What are the most common side effects for Humira?
Humira, a commonly prescribed medication for conditions like rheumatoid arthritis and psoriasis, may cause side effects that patients should be aware of. These include:
- Upper respiratory infections causing symptoms such as sore throat and stuffy nose
- Headaches or dizziness
- Rashes on the skin
- Stomach discomfort including nausea, vomiting, abdominal pain, loss of appetite or constipation
- Potential nervous system problems leading to tingling or numbness, possibly coupled with muscle weakness
- Increased frequency in urination
- On rare occasions it can cause more serious side effects like fast heartbeat or feelings of confusion and hostility.
However, most people tolerate Humira well without experiencing these issues. Always discuss any concerns with your healthcare professional before starting new medication.
Are there any potential serious side effects for Humira?
Humira, while effective for many people with inflammatory conditions, can occasionally cause severe side effects. Be aware of the following potential symptoms that may indicate a serious reaction:
- Signs of an allergic response such as hives, difficulty breathing or swallowing, swelling of your face or throat
- Symptoms indicative of heart failure like shortness of breath with exertion or lying flat in bed, rapid weight gain from fluid retention and swelling in the ankles or feet
- Symptoms related to nerve problems including weakness in arms/legs, numbness or tingling throughout your body, vision changes and balance issues (indicative of multiple sclerosis-like condition)
- Liver problem signs which include nausea/vomiting that doesn't stop, loss of appetite leading to rapid weight loss, dark urine coloration and yellowing skin/eyes
- Blood disorders evidenced by persistent bleeding/bruising easily, persistent fatigue/weakness.
If you experience any unusual symptoms while on Humira therapy it would be essential to seek immediate medical attention.
Contraindications for Cosentyx and Humira?
Both Cosentyx and Humira, along with most other immunosuppressive medications, may increase the risk of infections. If you notice symptoms such as fever, sweats or chills, muscle aches, coughs, shortness of breath; warm, red or painful skin or sores on your body; diarrhea or stomach pain; burning when you urinate or urinating more often than normal; feeling very tired etc., please seek immediate medical attention.
Neither Cosentyx nor Humira should be taken if you are taking live vaccines. Always tell your physician which medications and vaccinations you have had recently; live vaccines will require a period of about 6 weeks to clear from the system to prevent dangerous interactions with Cosentyx and Humira. Additionally, these drugs may also cause complications in patients with existing severe heart failure conditions. So it is crucial that all pre-existing health issues are fully disclosed to your healthcare provider before starting treatment.
How much do Cosentyx and Humira cost?
For the brand name versions of these drugs:
- The price for two injections (300 mg) of Cosentyx averages around $6200, which works out to approximately $100-$200 per day based on whether you're dosing weekly or monthly.
- For Humira, the cost is roughly $5700 for two pens (80 mg each), which also equates to about $90–$180/day depending on your dose frequency.
Thus, if you are in a higher dosage range for Cosentyx (i.e., 300 mg/week), then Humira is less expensive on a per-day treatment basis. However, it's important that cost should not be the primary consideration when determining which drug is right for you.
Currently there are no generic versions available for either Cosentyx (secukinumab) or Humira (adalimumab). Both medications fall under biologics and biosimilars might become available once their patents expire but until then costs will remain high.
Popularity of Cosentyx and Humira
Secukinumab, commonly known by its brand name Cosentyx, is an IL-17A inhibitor that was prescribed to approximately 300,000 people in the United States in 2020. This drug has seen a steady increase since its approval in 2015 and accounts for just over 13% of prescriptions among biologics used to treat psoriasis.
Adalimumab, better recognized as Humira, is a TNF alpha blocker that continues to dominate the market with around 2 million prescriptions filled across various indications such as rheumatoid arthritis and Crohn's disease among others. In terms of overall use among biologic drugs prescribed for conditions like psoriasis or rheumatoid arthritis, it accounted for nearly 50% of all prescriptions. While there have been slight fluctuations year on year due to availability of biosimilars and other newer agents entering the market, Humira’s prevalence remains substantial despite being available since early 2003.
Conclusion
Both Cosentyx (secukinumab) and Humira (adalimumab) have established records of usage in patients with conditions such as psoriasis, ankylosing spondylitis, and rheumatoid arthritis. They are backed by numerous clinical trials indicating that they are more effective than placebo treatments. In some cases, the drugs may be used together under careful consideration by a physician as they work through different mechanisms of action - Cosentyx inhibits interleukin-17A while Humira blocks tumor necrosis factor alpha.
Cosentyx is often considered for use in patients who did not respond well to first-line treatments or those allergic to them. On the other hand, Humira has been around longer and has broader approval for various inflammatory diseases including Crohn's disease and ulcerative colitis which Cosentyx does not cover.
Both medications come only in brand form currently, representing significant expenses especially for those paying out of pocket. Both may require an adjustment period after starting treatment before noticeable effects can be seen.
The side effect profiles between the two drugs are similar with both being generally well-tolerated but potential serious side effects include infections due to their immunosuppressive properties. For both Cosentyx and Humira users should closely monitor any changes in their health when starting treatment, particularly signs of infection like fever or persistent sore throat.