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Plegridy vs Tecfidera
Introduction
For patients with multiple sclerosis (MS), a neurological disorder that affects the central nervous system, certain drugs can help manage symptoms and slow disease progression. Plegridy and Tecfidera are two such drugs typically prescribed for individuals with relapsing forms of MS. Both target different aspects of the immune response but have proven effective in reducing flare-ups and slowing down physical disability. Plegridy is an interferon beta-1a medication, working to modulate the body's immune response and reduce inflammation in the brain and spine. On the other hand, Tecfidera is classified as an oral fumarate, which activates a pathway inside cells associated with protection against damage like that observed in MS while also having anti-inflammatory effects.
What is Plegridy?
Peginterferon beta-1a (the generic name for Plegridy) is a biologic medication used in the treatment of relapsing forms of multiple sclerosis (MS). It was first approved by the FDA in 2014. Plegridy works by modifying the body's immune response to reduce inflammation. It is administered via subcutaneous injection every two weeks, which makes it more convenient for patients compared to daily or weekly medications.
On the other hand, Dimethyl fumarate (the generic name for Tecfidera) also treats MS but has a different mechanism of action and administration route. Tecfidera protects nerve cells from damage and reduces inflammation by activating certain pathways in cells. Unlike Plegridy, Tecfidera comes as an oral capsule taken twice daily.
Both drugs can have side effects; however, they differ based on their mechanisms and routes of administration: flu-like symptoms are common with Plegridy due to its mode of administration while flushing and gastrointestinal issues are more common with Tecfidera because it is an oral drug.
What conditions is Plegridy approved to treat?
Plegridy is approved for the treatment of different variations of multiple sclerosis:
- Relapsing-remitting multiple sclerosis (RRMS), which is characterized by periods of new or increasing neurological symptoms followed by periods of partial or complete recovery
- Active secondary progressive multiple sclerosis (SPMS), a more advanced stage where there are still relapses but also progression in disability even without relapse. Tecfidera, on the other hand, is only indicated for Relapsing Forms Of Multiple Sclerosis (RFMS). It's not recommended for active SPMS.
How does Plegridy help with these illnesses?
Plegridy works to manage multiple sclerosis by reducing the frequency of flare-ups and slowing down the physical disability associated with this condition. It does this by acting like interferon beta, a naturally occurring protein in the body that regulates inflammation and immune responses. Plegridy mimics this protein's effects, thereby helping to control the autoimmune reactions that cause damage in multiple sclerosis. This medication is injected under the skin or into a muscle every two weeks, which can be done at home.
In contrast, Tecfidera is an oral medication taken twice daily for managing relapsing forms of multiple sclerosis. It works differently from Plegridy; its active ingredient dimethyl fumarate modulates immune responses but also has antioxidant properties that protect nerve cells from damage. Both medications have been shown effective in reducing relapses and delaying disease progression, but they differ significantly in their administration method and mechanism of action.
What is Tecfidera?
Tecfidera is a brand name for dimethyl fumarate, an oral medication used primarily in the treatment of relapsing forms of multiple sclerosis (MS). It functions by reducing inflammation and protecting against damage to the nervous system. Tecfidera was first approved by the FDA in 2013. Unlike Plegridy, which is an injectable interferon-based drug that modulates immune response, Tecfidera does not require injections as it comes in a pill form. This makes it more convenient for many patients than injectable medications like Plegridy. The side-effect profile of Tecfidera is also different from that of Plegridy - while both can cause flu-like symptoms or reactions at the injection site (for Plegridy), Tecfidera may lead to flushing and stomach problems but does not cause injection-related issues considering its oral administration route. The effects on inflammation and neural protection make it beneficial for treating MS, especially among patients who are reluctant about self-injecting treatments such as Plegridy.
What conditions is Tecfidera approved to treat?
Tecfidera is an oral medication approved for the treatment of patients with:
- Relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease This emphasizes Tecfidera's role in managing various types of MS conditions.
How does Tecfidera help with these illnesses?
Dimethyl fumarate, the active ingredient in Tecfidera, exerts its therapeutic effects by activating a pathway known as Nrf2. This is a crucial aspect of the body's response to oxidative stress and inflammation, both implicated in multiple sclerosis (MS). By activating this pathway, Tecfidera can protect nerve cells from damage and reduce the immune system's attack on the myelin sheath that insulates these cells. Unlike Plegridy which works by modulating the immune system’s inflammatory response more broadly – thus potentially leading to side effects such as flu-like symptoms – Tecfidera offers a more targeted approach. Therefore, it may be prescribed when a patient does not respond well or tolerate other 'typical' MS treatments like interferon-based drugs such as Plegridy.
How effective are both Plegridy and Tecfidera?
Plegridy and Tecfidera are both FDA-approved treatments for relapsing forms of multiple sclerosis (MS), with Plegridy being approved in 2014 and Tecfidera gaining approval a year earlier in 2013. As they have different mechanisms of action, they may be prescribed under different circumstances. Plegridy is an interferon beta-1a medication that modulates the body's immune response to reduce inflammation, while Tecfidera is a disease modifying treatment that activates the nuclear factor (erythroid-derived 2)-like 2 transcriptional pathway to protect nerve cells from damage.
The effectiveness of Plegridy was assessed in a two-year clinical trial where it demonstrated significant reductions in annualized relapse rates compared to placebo. It also showed benefits in other metrics such as delaying physical disability progression and reducing the number of new or enlarging brain lesions on MRI scans.
Similarly, Tecfidera was evaluated for its efficacy through two separate trials where it exhibited statistically significant reduced relapse rates when compared with either placebo or glatiramer acetate, another MS therapy. In these studies, Tecfidera also decreased the proportion of patients who experienced a relapse and slowed down physical disability progression.
A comparison study between interferons like Plegridy and oral drugs like Tecfidera shows mixed results across various parameters including patient adherence, side effects profile, risk-benefit balance among others. While there hasn't been any head-to-head trials comparing Plegridy against Tecfidera directly yet; individual preferences regarding route of administration (injectable vs oral) along with doctor consultation about potential risks might steer patient choice towards one over another.
At what dose is Plegridy typically prescribed?
Dosages of Plegridy for the treatment of multiple sclerosis begin with a starter dose, followed by a titration schedule. The initial dose is 63 micrograms subcutaneously every two weeks, and then it gradually increases to 94 micrograms and finally to the full dose of 125 micrograms over four weeks. Similarly, Tecfidera is taken orally starting with a lower dose at 120 mg twice daily for one week. After that period, if well tolerated, the dosage can be increased to its maintenance level at 240 mg twice daily. Both medications are adjusted based on individual tolerance and response but should not exceed their maximum recommended doses.
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At what dose is Tecfidera typically prescribed?
Tecfidera treatment is typically initiated at a dosage of 120 mg twice daily for the first week. Following this, the dose is increased to the full maintenance dose of 240 mg taken twice daily. The two doses should be evenly spaced throughout the day and taken approximately 12 hours apart. If adverse reactions such as flushing or gastrointestinal problems occur, temporary dose reductions back to 120 mg twice daily may be considered. It's crucial to maintain regular monitoring with your doctor if there’s no improvement in symptoms after a few weeks on Tecfidera or if side effects persist.
What are the most common side effects for Plegridy?
Common side effects of Plegridy can include:
- Flulike symptoms (body aches, chills, fever)
- Headaches
- Injection site reactions (redness, itching, pain)
- Asthenia (general weakness and fatigue)
- Diarrhea
- Nausea
Meanwhile, side effects associated with Tecfidera are:
- Abdominal pain
- Vomiting
- Nausea
- Diarrhea
- Indigestion or heartburn
- Flushing or hot flashes
Remember to consult with your healthcare provider for information about these drugs' potential risks and benefits.
Are there any potential serious side effects for Plegridy?
While Plegridy and Tecfidera are both used to treat relapsing forms of multiple sclerosis, they do have different side effects. For Plegridy, the potential serious side effects include:
- Depression or suicidal thoughts
- Allergic reactions such as skin rash, itching or hives, swelling of the face, lips or tongue
- Breathing problems
- Heart conditions like chest pain; irregular heart beats; rapid pulse; palpitations
- Vision changes
- Liver issues with symptoms including yellowing eyes/skin, dark urine, severe stomach/abdominal pain
For Tecfidera on the other hand:
- An allergic reaction is possible: rash; difficulty breathing; tightness in the chest; swelling of your mouth, face,lips or tongue.
- It may lower white blood cell count leading to an increased risk for infections - signs might include fever,chills,persistent sore throat,cough that doesn't go away.
- Flushing and stomach problems are common but if these persist or worsen,tell your doctor promptly.
Remember that it's crucial to monitor any new medication closely for any unexpected adverse events and discuss them immediately with your healthcare provider.
What are the most common side effects for Tecfidera?
Tecfidera may cause a variety of side effects, some of which include:
- Flushing (warmth, redness, or tingly feeling)
- Nausea, vomiting, diarrhea
- Stomach pain or indigestion
- Loss of appetite
- Headache
- Itching and rash
- Increased urination frequency -Dizziness
More serious symptoms can also occur with Tecfidera such as chest pain or discomfort. Always consult your healthcare professional if you experience any unusual symptoms while on this medication.
Are there any potential serious side effects for Tecfidera?
While Tecfidera is a popular choice for certain medical conditions, it's crucial to monitor your body closely while taking this medication. Some of the more serious potential side effects can include:
- Signs of an allergic reaction such as hives, itching, difficulty breathing or swallowing, swelling in your face or throat.
- A severe skin reaction that causes burning eyes, skin pain and redness followed by a purple rash that spreads (particularly in the face or upper body) causing blistering and peeling.
- Changes in mental state such as confusion or unusual mood swings
- Sudden vision changes like blurred vision and seeing halos around lights
- Fast or irregular heartbeats Extreme behavioral changes indicative of a manic episode such as racing thoughts, increased energy levels, reckless conduct, extreme happiness or irritability combined with lack of sleep.
If you notice any of these symptoms after starting Tecfidera treatment, you should seek immediate medical assistance.
Contraindications for Plegridy and Tecfidera?
Both Plegridy and Tecfidera, like most medications for multiple sclerosis (MS), may exacerbate certain symptoms in some patients. If you notice worsening of your MS symptoms or any unexpected side effects, seek immediate medical attention.
Neither Plegridy nor Tecfidera should be taken if you are taking other immunosuppressive drugs or have a history of severe liver disease without the explicit advice and monitoring by your physician. Always inform your doctor about all the medications that you are currently taking; using these drugs concurrently may require special precautions to avoid potentially harmful interactions.
It's important to note that both Plegridy and Tecfidera can cause serious side effects such as liver problems and allergic reactions. Therefore, it is essential for individuals on these treatments to have regular blood tests to monitor their health status.
How much do Plegridy and Tecfidera cost?
For the brand-name versions of these drugs:
- The price for a one-month supply of Plegridy (125 mcg) averages around $7,500 which works out to approximately $250/day.
- The price for a 60-capsule pack of Tecfidera (240 mg) is about $5,800, working out to roughly $193/day.
Thus, if you are taking only one dose per day as recommended by most doctors for either drug, then brand-name Tecfidera is less expensive on a per-day treatment basis. Please note that cost should not be your primary consideration in determining which of these drugs is right for you.
As far as generic versions are concerned:
- There currently isn't any available generic version for either Plegridy or Tecfidera. This means costs remain significantly high and present affordability challenges unless covered by insurance plans.
Remember that prices can vary depending on location and whether you have insurance coverage. Always consult with healthcare professionals before making decisions based on cost alone. Your health and effective management of your condition should always come first when choosing between medicines like Plegridy and Tecfidera.
Popularity of Plegridy and Tecfidera
Peginterferon beta-1a, sold under the brand name Plegridy, is an injectable medication used in the treatment of relapsing forms of multiple sclerosis (MS). It was estimated that about 65,000 people in the US were prescribed peginterferon beta-1a or similar drugs in 2020. This class of medications accounted for just over 10% of total MS prescriptions in the US and has seen a steady increase since its introduction.
Dimethyl fumarate, also known as Tecfidera, was prescribed to approximately 85,000 people with MS in the USA during 2020. In terms of overall usage among patients with MS, dimethyl fumarate accounts for about 14% of all disease-modifying therapies (DMTs), making it one of the most commonly used oral DMTs on the market today. The prevalence rate for dimethyl fumarate prescription has remained relatively stable over recent years.
Conclusion
Both Plegridy (peginterferon beta-1a) and Tecfidera (dimethyl fumarate) are established therapies for relapsing-remitting multiple sclerosis, with numerous clinical studies indicating their effectiveness in reducing the number of relapses compared to placebo. Both drugs have different mechanisms of action: Plegridy works by modifying the immune system's response, while Tecfidera protects against oxidative stress that might harm nerve cells.
Plegridy is usually administered as a subcutaneous injection every two weeks, which may be more convenient for patients who prefer less frequent dosages. On the other hand, Tecfidera is an oral medication taken twice daily.
Both medications come with potential side effects. Common side effects of Plegridy include flu-like symptoms after administration and injection site reactions. Tecfidera can cause flushing and stomach issues like nausea or diarrhea. Patients must monitor their health closely when starting these treatments, particularly because both can affect white blood cell counts and liver function.
Neither drug has a generic form available currently; therefore cost considerations may play a role in choosing between these two options for some patients - this should be discussed with your healthcare provider.