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Tremfya vs Humira
Introduction
For patients with moderate to severe plaque psoriasis or other chronic inflammatory conditions, certain drugs that target and inhibit specific proteins involved in the inflammatory process can help in reducing symptoms and improving overall quality of life. Tremfya and Humira are two such drugs often prescribed for these conditions. They each have a different mechanism of action but both work towards managing inflammation caused by overactive immune responses. Tremfya is a human monoclonal antibody that selectively binds to interleukin 23 (IL-23), a cytokine which plays a key role in managing the immune system and inflammation. Humira, on the other hand, is classified as an anti-tumor necrosis factor (TNF) agent; it works by blocking TNF-alpha, another protein involved in systemic inflammation found excessively in several autoimmune diseases.
What is Tremfya?
Guselkumab (the generic name for Tremfya) is a type of medication that belongs to the class of drugs known as interleukin inhibitors, which marked an important development from the earlier TNF-alpha inhibitor medications. Guselkumab was first approved by the FDA in 2017. It operates by targeting and blocking a specific protein in your body – IL-23 – thereby reducing inflammation and slowing down cell growth. It's prescribed primarily for treating moderate to severe plaque psoriasis in adults who may benefit from taking systemic therapy or phototherapy.
Adalimumab (the generic name for Humira), on the other hand, is a different type of biologic drug classified as a TNF-alpha inhibitor, which not only treats plaque psoriasis but also several other autoimmune conditions like rheumatoid arthritis and Crohn’s disease.
While both these drugs are designed to help manage symptoms of various inflammatory conditions, they work differently within your immune system. Tremfya focuses specifically on IL-23, with no significant influence on other cytokines such as TNF-alpha or IL-17A; this targeted approach results in it having fewer side effects than broader-based treatments like Humira that affect multiple aspects of your immune response.
What conditions is Tremfya approved to treat?
Tremfya has been approved for the treatment of several different conditions:
- Moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.
- Active psoriatic arthritis in adults, used alone or in combination with a non-biologic disease-modifying antirheumatic drug (DMARD).
Humira is also approved for similar conditions and more. It's important to consult your healthcare provider before deciding on any medication.
How does Tremfya help with these illnesses?
Tremfya helps to manage psoriasis by selectively blocking the protein interleukin-23 (IL-23), a key factor in the overactive immune response that causes inflammation and skin cell proliferation associated with psoriasis. It does this by binding to IL-23, preventing it from interacting with its receptor on the surface of immune cells, thereby dampening down the inflammatory response. Inflammation is an integral process in our bodies' defense mechanisms, playing a critical role in healing and fighting off infections. However, when misdirected or overly active as seen in conditions like psoriasis, it can lead to damaging effects such as redness, swelling and discomfort among other symptoms related to this disease.
Therefore by targeting IL-23 specifically rather than broadly suppressing the entire immune system —which could leave patients susceptible to infections— Tremfya offers a more focused approach towards limiting these unwanted effects of inflammation caused due to psoriasis and helping patients manage their condition more effectively.
What is Humira?
Humira, a brand name for adalimumab, is an anti-TNF alpha monoclonal antibody. This means it targets and inhibits the action of tumor necrosis factor-alpha (TNFα), a substance in the body that causes inflammation. Humira was first approved by the FDA in 2002 and has since been used to treat numerous conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis and plaque psoriasis.
Unlike Tremfya which specifically targets interleukin-23 (IL-23), another pro-inflammatory cytokine involved in autoimmune diseases like plaque psoriasis but not other inflammatory disorders treated by Humira. Due to its wider range of application - treating multiple immune-mediated inflammatory disorders - Humira may be chosen over Tremfya for patients with concurrent conditions such as rheumatoid arthritis or Crohn’s Disease.
However, because it affects more pathways in the immune system than Tremfya does, there is potential for greater side effects with Humira use including infections due to immunosuppression which could potentially be serious. Nevertheless just like other medications benefits should always be weighed against potential risks when considering treatment options.
What conditions is Humira approved to treat?
Humira is a widely used medication that has received FDA approval for the treatment of several conditions, including:
- Rheumatoid arthritis
- Psoriatic arthritis
- Ankylosing spondylitis
- Crohn's disease in adults and children aged six and above.
- Ulcerative colitis This multifaceted drug also treats plaque psoriasis in adults who are ready for systemic therapy or phototherapy.
How does Humira help with these illnesses?
Tumor Necrosis Factor (TNF) is a cytokine involved in systemic inflammation and is found to be increased in various autoimmune diseases. Humira, generically known as adalimumab, works by binding to TNF-alpha, effectively blocking its interaction with the cell surface receptors. Thus, it inhibits the inflammatory response that contributes to symptoms of conditions like rheumatoid arthritis and psoriasis. Its mechanism of action differs from Tremfya which targets interleukin-23, another protein involved in immune responses. Because Humira has a broader scope of approved uses including Crohn's disease and ulcerative colitis among others—conditions not treated by Tremfya—it may be prescribed when patients have multiple co-existing autoimmune disorders or do not respond optimally to other medications.
How effective are both Tremfya and Humira?
Both guselkumab (Tremfya) and adalimumab (Humira) are established treatments for psoriasis, though they were approved by the FDA at different times with Humira being introduced first. They work via differing mechanisms of action, targeting separate aspects of the immune response that contributes to psoriasis; therefore, they may be prescribed under varying circumstances.
The effectiveness of Tremfya and Humira was directly studied in a double-blind clinical trial in 2017 known as the VOYAGE 1 study. Both drugs showed significant efficacy in managing symptoms of moderate to severe plaque psoriasis. In this study, patients receiving Tremfya experienced higher rates of skin clearance compared to those on Humira after both 16 and 48 weeks.
A review published in The Lancet reported that within one month from starting treatment with Guselkumab, patients saw an improvement in their symptoms with minimal side effects, demonstrating its rapid onset of action. This makes it a preferred choice for many clinicians when treating moderate-to-severe plaque psoriasis. Further studies have shown favorable results even among elderly populations who tend to experience more side effects with systemic therapies due to multiple comorbidities.
While Adalimumab continues to be highly effective against various autoimmune disorders including rheumatoid arthritis and Crohn's disease alongside plaque psoriasis— making it one of the most widely used biologics worldwide —it falls behind Guselkumab specifically when treating psoriasis according to some metrics such as PASI-90 scores measuring severity reduction levels.
Despite adalimumab's broader spectrum usage across several diseases leading it usually prescribed before or along other biologic agents like Tremfya—its use alone has been seen less robust than combining therapy where needed especially considering long-term management due its immunosuppressive nature which can cause serious infections over time. Nonetheless given unique profiles these medications offer diverse choices catering individual needs avoiding certain adverse events—for instance avoid triggering latent tuberculosis infection—a concern regarding Humira treatment.
At what dose is Tremfya typically prescribed?
Dosages of Tremfya (guselkumab) are typically administered as a 100 mg subcutaneous injection at the start, followed by another dose four weeks later and then every eight weeks thereafter. Studies have shown this to be an effective dosage for managing moderate-to-severe plaque psoriasis in most adults. Similarly, Humira (adalimumab) is often initiated with a loading dose of 160 mg, usually given as four 40 mg injections in one day or two 40 mg injections per day for two days. Following the initial dosage, it's typically prescribed at 40 mg every other week. However, depending on the response and tolerability in individual patients, dosing frequency may need adjustment over time under doctor's guidance. It should be noted that both drugs are not recommended for use in children due to lack of clinical safety data.
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At what dose is Humira typically prescribed?
Humira treatment is generally initiated with a loading dose of 160mg, which can be administered as four injections in one day or two injections per day for two consecutive days. Afterwards, the typical dosing schedule comprises of a 80mg injection every other week starting one week after the initial dosage. For certain conditions like Psoriatic arthritis and Ankylosing spondylitis, the maintenance dose could be increased to 40mg every week or 80mg every other week. It's important that adjustments are based on individual patient response over time. If there’s little to no improvement observed within a few weeks of therapy initiation at this regimen, your healthcare professional may consider an alternative treatment approach.
What are the most common side effects for Tremfya?
Common side effects that can occur with Tremfya include:
- Upper respiratory infections
- Headache
- Injection site reactions (such as redness, swelling, and pain at the injection site)
- Diarrhea
On the other hand, Humira may cause:
- Respiratory infections (such as sinusitis and pharyngitis)
- Headache
- Rash
- Nausea
- Abdominal pain
- Urinary tract infection
- High blood pressure -Injection site reactions
Always consult your healthcare provider for any concerns about these potential side effects.
Are there any potential serious side effects for Tremfya?
When comparing Tremfya to Humira, it's vital to note the potential adverse effects of each. The serious side-effects associated with Tremfya may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face or throat
- New or worsening symptoms of inflammatory bowel disease (stomach pain, diarrhea, weight loss)
- Symptoms related to infections: fever, chills, muscle aches, coughing up mucus or blood
- Skin changes like redness where the medicine was injected
On the other hand, Humira might cause more severe reactions including:
- A lupus-like syndrome - joint pain and swelling coupled with a rash on the cheeks or arms that worsens in sunlight.
- Liver problems - nausea/upset stomach, fatigue/weakness/dizziness/lightheadedness which could lead to fainting spells and potentially jaundice.
- Nervous system problems – numbness/tingling/sudden vision changes/seizures.
Remember: If you experience any unusual health-related issues while taking either medication — even if they're not listed above — it’s always best to consult your healthcare provider promptly.
What are the most common side effects for Humira?
Humira, similar to Tremfya, is often used to treat conditions such as psoriasis and rheumatoid arthritis. However, the side effects can be quite different. Some of the most common side effects of Humira include:
- Respiratory infections including sinus infections and sore throat
- Headache
- Rash or skin reactions at the injection site
- Nausea and abdominal pain
- Fatigue
- Increased risk for developing serious infections which may lead to hospitalization or death.
It's also worth noting that on rare occasions, some individuals may experience an allergic reaction to Humira resulting in hives, difficulty breathing or swelling of the face, lips tongue or throat. Furthermore, long term use of Humira can potentially lead to nerve damage causing tingling or a sensation of numbness throughout various parts of your body.
Are there any potential serious side effects for Humira?
While Humira is a widely used medication, it does come with potential risks. Severe side effects may include:
- Signs of allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
- Serious infections symptoms: fever, sweats or chills, muscle aches, cough that doesn't go away or leads to shortness of breath and severe fatigue.
- Nervous system problems such as multiple sclerosis-like syndrome manifesting as changes in vision or speech; weakness on one side of the body; neck stiffness; loss of balance.
- Heart failure signs like shortness of breath (especially when lying down), sudden weight gain due to fluid retention and swelling in ankles or feet.
- Liver problems including jaundice (yellowing skin/eyes), dark urine and upper abdominal pain.
If you experience any such serious side effects while using Humira, immediately contact your healthcare provider.
Contraindications for Tremfya and Humira?
Tremfya and Humira, like most medications for autoimmune conditions, may worsen symptoms in some people. If you notice your condition worsening or if you experience severe side effects such as persistent fever, bruising or bleeding easily, shortness of breath, or changes in skin appearance (rashes or lesions), please seek immediate medical attention.
Neither Tremfya nor Humira should be taken if you are taking, have been recently vaccinated with a live vaccine or plan to get one soon. It's imperative that your doctor knows about all the medications and treatments you are receiving; live vaccines need time to clear from the system to prevent dangerous interactions with Tremfya and Humira.
Due to their immunosuppressive nature, both drugs increase susceptibility to infections – this includes common ones like flu and serious ones like tuberculosis. Therefore it is important that any signs of infection be immediately reported to a healthcare provider.
It is also worth noting that while both drugs can help manage psoriasis symptoms by reducing inflammation in the body; they work differently at a molecular level which results in different efficacy profiles for patients based on their individual health status.
How much do Tremfya and Humira cost?
For the brand name versions of these drugs:
- The price for one syringe (100 mg) of Tremfya averages around $5800, which works out to approximately $1933/month since it's administered once every four weeks.
- The price for two pens (40 mg each) of Humira is about $5157, working out to roughly $2578/month as it typically needs administering every other week.
Thus, if you are considering monthly cost, then Tremfya may be less expensive than Humira on a per-month treatment basis. However, please note that cost should not be a primary consideration in determining which drug is right for you.
As biologic medications, there currently aren't generic versions available for either Tremfya or Humira due to their complex molecular structures and manufacturing processes. It's important to remember that while prices can vary widely depending on insurance coverage and pharmacy location, both medications have programs designed to help reduce costs for eligible patients.
Popularity of Tremfya and Humira
Adalimumab, sold under the brand name Humira among others, is a medication used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis and plaque psoriasis. In 2020 alone, it was estimated that about 5 million people in the US were treated with Adalimumab making it one of the most commonly prescribed biologics for autoimmune diseases.
Guselkumab or Tremfya on the other hand is primarily used to manage moderate-to-severe forms of plaque psoriasis. While not as widely utilized as Humira due to its narrower range of indications and its later introduction to market (FDA approved in 2017), Guselkumab has been recognized for its effectiveness specifically against plaque psoriasis. It has seen steady growth since its debut with approximately half a million prescriptions written in 2020. Both drugs have different mechanisms of action though both are part of the larger group known as biologics.
Conclusion
Both Tremfya (guselkumab) and Humira (adalimumab) have been approved to manage moderate-to-severe plaque psoriasis, rheumatoid arthritis, and certain other inflammatory conditions. Their efficacy is backed by multiple clinical trials showing that they are more effective than placebo treatments. It is uncommon for these drugs to be combined due to their similar mechanisms of action - both being biologics that target specific proteins involved in the inflammatory process.
Tremfya targets a protein called IL-23 while Humira inhibits TNF-alpha; as such, they are prescribed under different circumstances based on patient response or disease specifics. While there's no hard rule about which comes first, often physicians consider factors like insurance coverage and the presence of comorbidities when deciding between them.
As with most biologic medications, neither drug has a generic form available at this time, meaning out-of-pocket costs can be high if the medication isn't covered under your insurance plan.
Starting treatment with either Tremfya or Humira may not result in immediate symptom relief; an adjustment period can be expected before effects become noticeable.
The side effect profiles of Tremfya and Humira do share similarities but also show differences based on their mechanism of action. With both drugs patients should monitor for signs of infection as these medications can lower your ability to fight infections. Any new symptoms or worsening condition should warrant immediate medical attention.