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Inflectra vs Entyvio
Introduction
For patients with inflammatory bowel disease (IBD) like Crohn's disease or ulcerative colitis, certain medications that influence the immune response can help in managing symptoms and inducing remission. Inflectra and Entyvio are two such drugs that are commonly prescribed for IBD. They each interact differently with the body's immune system but both have significant effects on controlling inflammation in patients with IBD.
Inflectra is a biosimilar to Remicade, classed as an anti-TNF agent; it works by blocking a protein called tumor necrosis factor-alpha (TNF-α), which plays a key role in causing inflammation in the body. On the other hand, Entyvio operates on gut-specific integrin antagonism; it precisely targets α4β7 integrin and inhibits its binding to MAdCAM-1, reducing inflammation specifically within the gastrointestinal tract without broadly suppressing other areas of the immune system.
What is Inflectra?
Inflectra (generic name infliximab) belongs to the class of drugs known as TNF inhibitors. It marked a significant progression from older classes of medication for inflammatory bowel disease, among other conditions. Inflectra was approved by the FDA in 2016 and works by blocking tumor necrosis factor alpha (TNFα), a pro-inflammatory molecule, thereby reducing inflammation throughout the body. It is generally administered intravenously for severe forms of Crohn's disease and ulcerative colitis.
On the other hand, Vedolizumab, sold under the brand name Entyvio, is an integrin receptor antagonist used for treating moderate to severe ulcerative colitis or Crohn’s disease. The primary difference between these two medications lies in their specificity: while Inflectra has systemic effects on inflammation across all tissues of the body that might result in more side effects; Entyvio specifically targets inflammation within intestinal cells which may provide fewer overall side effects.
What conditions is Inflectra approved to treat?
Inflectra and Entyvio have both been approved for the treatment of several autoimmune conditions:
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Inflectra is used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease in adults and children who are at least six years old, ulcerative colitis in adults and children who are at least six years old.
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Entyvio on the other hand is indicated for use with Ulcerative Colitis (UC) where it helps by controlling symptoms, inducing and maintaining remission, improving endoscopic findings as well as achieving corticosteroid-free remission. It also finds application in treating adult patients with moderately to severely active Crohn’s Disease (CD), particularly those that exhibit inadequate response or intolerance towards one or more TNF blocker therapies.
How does Inflectra help with these illnesses?
Inflectra aids in the management of autoimmune diseases like rheumatoid arthritis and inflammatory bowel disease by inhibiting a protein called tumor necrosis factor alpha (TNF-alpha) found in your body's immune system. This protein plays an essential role in inflammation, which is beneficial when it comes to wound healing or combating infections but can be harmful if overactive, leading to autoimmune disorders where the body attacks its own tissues. By blocking TNF-alpha, Inflectra reduces the symptoms of these conditions and helps patients manage their illness more effectively.
On the other hand, Entyvio works differently as it specifically targets α4β7 integrin, a protein that regulates white blood cell movement into certain areas of the gut. By blocking this protein's action, Entyvio prevents excessive migration of white blood cells into gut tissues thereby reducing inflammation only in this specific area rather than throughout the whole body like Inflectra does. This makes Entyvio particularly useful for managing conditions affecting gastrointestinal tract such as ulcerative colitis and Crohn’s disease.
What is Entyvio?
Entyvio, or vedolizumab, is a monoclonal antibody medication used primarily for the treatment of Ulcerative colitis and Crohn's disease. It specifically targets and blocks the action of alpha4-beta7 integrins which are key players in inflammation processes specific to these conditions. Its selective mode of action allows it to focus on gut-specific inflammation without impacting systemic immune responses. Entyvio was approved by the FDA in 2014. Unlike Inflectra (Infliximab), an anti-TNF-α that works by blocking the inflammatory cytokine TNF-alpha throughout the body, Entyvio operates only within the gastrointestinal tract, thus avoiding many potential side effects associated with global immunosuppression such as increased risk of infections or malignancies. This selectivity may make it a more attractive option for patients who have not responded well to broader acting biologics like Inflectra or those who are concerned about systemic side effects.
What conditions is Entyvio approved to treat?
Entyvio is a biologic medication that's been approved for the management of:
- Moderate to severe ulcerative colitis, which is an inflammatory bowel disease causing long-lasting inflammation and ulcers in your digestive tract.
- Moderate to severe Crohn’s disease, another type of inflammatory bowel disease that often leads to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition.
Entyvio works by reducing the effects of proteins in your body that can cause inflammation.
How does Entyvio help with these illnesses?
Entyvio, like Inflectra, is often used in the treatment of inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. Entyvio works by blocking a specific protein called integrin which plays an important role in inflammation processes within the body. By targeting this specific protein, Entyvio can reduce intestinal inflammation and alleviate symptoms associated with these conditions. Its action on lymphocytes selectively affects gut-specific immunity, reducing overall systemic side effects. Moreover, unlike Inflectra that targets TNF-alpha – a more general approach to reducing inflammation – Entyvio specifically focuses on the gut which could make it more suitable for patients who do not respond well to broad-spectrum biologics or are concerned about their potential side effects.
How effective are both Inflectra and Entyvio?
Both Inflectra (infliximab-dyyb, a biosimilar to Remicade) and Entyvio (vedolizumab) are successful treatments for inflammatory bowel diseases including Crohn's disease and ulcerative colitis. They were approved by the FDA in 2016 and 2014 respectively. Both drugs act on different targets within the immune system to reduce inflammation: Inflectra inhibits TNF-alpha, a pro-inflammatory cytokine, while Entyvio blocks integrin alpha-4-beta-7 that mediates leukocyte adhesion to gut vasculature.
A direct comparison of their effectiveness has not been performed yet in clinical trials; however both have shown good efficacy in managing symptoms of inflammatory bowel diseases separately. A review of multiple studies demonstrated that infliximab was effective at inducing remission in patients with moderate-to-severe active ulcerative colitis as early as week six of treatment with an optimal dose thought to be 5 mg/kg body weight.
A separate meta-analysis found vedolizumab also significantly improved rates of clinical response and remission compared to placebo in moderate-to-severe active Crohn's disease after up ten weeks treatment. While both drugs have comparable safety profile, some notable differences exist: unlike Inflectra which is systemic immunosuppressant , Entyvio specifically targets the gastrointestinal tract only thus potentially reducing systemic side effects risk.
Typically, choice between these medications may depend on individual patient factors such as disease severity or extent , previous exposure or response history to anti-TNF agents like infliximab or presence of extraintestinal manifestations where systemic action might be beneficial.
At what dose is Inflectra typically prescribed?
Inflectra dosages are usually administered as an intravenous infusion at 5 mg/kg over a two-hour period. This is typically done at weeks 0, 2 and 6, then every eight weeks thereafter. However, the dosage can be increased to up to 10 mg/kg or administration frequency to every six weeks based on individual patient response. Entyvio, on the other hand, is also given via intravenous infusion but at a fixed dose of 300 mg. The initial doses are given at week 0, week 2 and week 6 then continued every eight weeks thereafter depending on clinical response and disease severity. As with any medication regimen changes should only be made under medical supervision.
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At what dose is Entyvio typically prescribed?
Entyvio treatment is typically started with a 300 mg intravenous infusion. This initial dose is then followed by additional infusions at the second and sixth week of treatment. After this induction phase, maintenance doses are administered every eight weeks. Each dose remains consistent at 300 mg per session. If there's no response to Entyvio after fourteen weeks, your healthcare professional might review your case and decide whether or not to continue the medication.
What are the most common side effects for Inflectra?
Possible side effects of Inflectra include:
- Chest pain
- Shortness of breath
- Vision changes
- Weakness on one side of the body
- Increased heart rate
- Unusual weight loss/gain
- Swelling ankles/feet
- Unexplained muscle pain or tenderness
On the other hand, common side effects for Entyvio may include:
-Nasal congestion or runny nose (rhinitis)
-Sore throat and fever (pharyngitis)
-Influenza or flu-like symptoms
-Bronchitis
-Rash, itching
-Joint pain (arthralgia)
-Pain in extremities
-Tiredness (fatigue)
Always consult with your healthcare provider about potential side effects before starting a new medication.
Are there any potential serious side effects for Inflectra?
In rare cases, Inflectra can cause potentially serious side effects, which include:
- Signs of an infection such as fever, chills, aches and pains or cough
- Allergic reactions like skin rash, itching or hives; swelling of the face, lips or tongue
- Changes in vision
- Chest pain or chest tightness
- Difficulty breathing or wheezing
- Nervous system issues such as numbness/tingling; weakness on one side of the body; changes in balance; blurred/double vision
On the other hand with Entyvio you should be aware that it can also trigger serious adverse reactions. These might include:
- Infections: signs may include fever, tiredness and cough.
- Liver problems: if you notice yellowing of your skin and eyes (jaundice), severe nausea/vomiting/pain in your abdomen.
- Serious allergic reaction: symptoms could range from rashes/hives/itching/redness/swelling to difficulty breathing/tightening of your throat.
If any such symptoms occur while taking either medication do not delay seeking medical attention.
What are the most common side effects for Entyvio?
Entyvio, like any other medication, has its own set of potential side effects:
- Common cold symptoms such as stuffy nose, sore throat
- Headache or dizziness
- Fatigue or feeling tired
- Joint or back pain
- Nausea or mild stomach pain
- Mild rash on the skin
- Coughing and shortness of breath Nevertheless, it's important to note that not everyone will experience these side effects. In some cases, Entyvio can cause serious side effects like liver problems and infections; so immediate medical attention is required if you notice symptoms like persistent nausea/vomiting, dark urine, severe stomach/abdominal pain or yellowing eyes/skin.
Are there any potential serious side effects for Entyvio?
Entyvio, like all medications, can have side effects. Some of these may be serious and require immediate medical attention. These include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling in your face or throat.
- Symptoms that might indicate liver problems: nausea, upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools or jaundice (yellowing of the skin or eyes).
- Changes in your mental state such as feeling tired or confused.
- Signs of infection such as fever, chills or sore throat.
- Shortness of breath even with mild exertion
- Bloody or tarry stools If you notice any unusual changes while on Entyvio therapy do not hesitate to contact your healthcare provider immediately.
Contraindications for Inflectra and Entyvio?
Both Inflectra and Entyvio, along with most other immunosuppressive drugs, may increase the risk of infection. If you notice any signs of infection such as fever, cough or flu-like symptoms, please contact your doctor immediately.
Neither Inflectra nor Entyvio can be taken if you are taking certain live vaccines (like BCG for bladder cancer) or have been receiving biological treatments like Rituximab within the past few months. Always inform your physician about all medications and treatments that you're currently on; some require a specific duration to clear from your system in order to prevent dangerous interactions with both Inflectra and Entyvio.
Additionally, these medications should not be used by individuals who have had an allergic reaction to them in the past. They also pose risks to patients with heart failure conditions or those suffering from neurological disorders such as multiple sclerosis. Be sure to discuss any pre-existing health conditions with your healthcare provider before starting treatment.
How much do Inflectra and Entyvio cost?
For the brand name versions of these drugs:
- The price of one vial of Inflectra (100 mg), a biosimilar to Remicade, averages around $1100, which works out to $2200 per treatment every 8 weeks for an average patient.
- The price for one vial of Entyvio (300 mg) is about $6200. With standard dosing being once every 8 weeks after initial loading doses, this equates to approximately $775 per week.
Thus, if you are on regular maintenance dosing with these medications, then Inflectra tends to be less expensive on a per-treatment basis than Entyvio. However cost should not be the primary consideration in determining which of these drugs is right for you as both have different mechanisms and side effect profiles.
As biologic agents used in autoimmune conditions like Crohn's disease and Ulcerative colitis, neither Inflectra nor Entyvio currently have generic equivalents available due to their complex nature and production processes. Therefore costs remain high compared to many other classes of medications.
Popularity of Inflectra and Entyvio
Inflectra, the biosimilar of Remicade (infliximab), was prescribed to about 3.5 million people in the US in 2020. Inflectra accounted for just over 15% of anti-inflammatory prescriptions in the country. It has become increasingly prevalent as a treatment option since its introduction in 2016 due to its effectiveness and affordability compared with brand-name drugs.
Vedolizumab, sold under the brand name Entyvio, is another medication used to treat inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. In 2020, this drug was prescribed to approximately 1 million people across America. This accounts for around 10% of total prescriptions given for these conditions within that year. Over the past decade or so, vedolizumab usage has remained relatively steady due to its highly specific mechanism of action targeting inflammation specifically at gut level.
Conclusion
Both Inflectra (infliximab) and Entyvio (vedolizumab) have demonstrated effectiveness in the treatment of inflammatory bowel diseases like Crohn's disease and ulcerative colitis. They are supported by numerous clinical studies indicating their efficacy over placebo treatments. These two drugs may be used together, but this should be under careful consideration by a physician due to potential drug interactions.
Inflectra is a biosimilar to Remicade, functioning as a TNF-alpha inhibitor, while Entyvio works differently as it targets the alpha4-beta7 integrin. Therefore, they tend to be prescribed under different circumstances based on specific patient factors and disease characteristics.
In terms of cost-effectiveness, Inflectra may offer some savings being a biosimilar product that tends to be less expensive than the original biologic or newer medication options like Entyvio. Both Inflectra and Entyvio could require an adjustment period for patients' bodies to respond effectively.
The side effect profiles are similar between these two medications with both generally well-tolerated; however each has specific risks associated with its mechanism of action that must be considered when prescribing them. As with any potent immunosuppressive therapy, close monitoring for infection is required while on either medication.