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Cimzia vs Humira
Introduction
Patients suffering from autoimmune conditions such as rheumatoid arthritis, Crohn's disease, or psoriasis often require specific drugs to manage their symptoms. Cimzia and Humira are two medications commonly prescribed for these conditions. Both of them act by targeting tumor necrosis factor (TNF), a pro-inflammatory substance produced in the body which is overactive in people with autoimmune disorders.
Cimzia, also known as certolizumab pegol, works by binding to TNF and neutralizing its activity. Unlike other anti-TNF medications, certolizumab pegol does not contain an Fc region which might contribute to fewer side effects related to immune activation.
On the other hand, Humira or adalimumab binds specifically to TNF-alpha and blocks its interaction with cell surface receptors. This helps reduce inflammation caused by autoimmune diseases but may have potential adverse effects on immunity due to its broad action on inflammatory processes.
Despite having similar mechanisms of action and target specificity both drugs differ in their molecular structure leading potentially different efficacy profiles depending on patient’s individual response.
Cimzia vs Humira Side By Side
| Attribute | Cimzia | Humira |
|---|---|---|
| Brand Name | Cimzia | Humira |
| Contraindications | Should not be taken with any kind of biological therapy, latent tuberculosis, and live vaccines due to risk of causing infections. | Should not be taken with any kind of biological therapy, latent tuberculosis, and live vaccines due to risk of causing infections. |
| Cost | Around $4,500 for two injections (1.2 ml each), approximately $75/day | A pre-filled pen or syringe containing 40 mg costs about $5,600, taken every other week, translating into a daily cost around $95 |
| Generic Name | Certolizumab Pegol | Adalimumab |
| Most Serious Side Effect | Signs of infections, allergic reactions, neurologic reactions, heart failure, liver problems, blood disorders | Severe allergic reactions, nervous system problems, new heart failure symptoms, liver issues, unusual bleeding tendencies |
| Severe Drug Interactions | Biologics and live vaccines | Biologics and live vaccines |
| Typical Dose | 200 mg every two weeks or 400 mg every four weeks for rheumatoid arthritis | Initial loading dose of 160 mg, then 40 mg every other week, possibly increasing to once a week |
What is Cimzia?
Certolizumab Pegol (the generic name for Cimzia) and Adalimumab (the generic name for Humira) are both drugs that belong to the class of TNF-alpha inhibitors, which represent a major advancement from conventional nonsteroidal anti-inflammatory drugs. These medications were designed to treat various autoimmune disorders such as Crohn's disease, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and plaque psoriasis. Certolizumab Pegol was approved by the FDA in 2008. It works by blocking the activity of TNF-alpha, a protein in the body that causes inflammation; effectively reducing inflammation and stopping disease progression. While both medications work in similar ways by inhibiting TNF-alpha action thus reducing inflammation, Cimzia has been engineered with a unique PEGylation process that extends its therapeutic effects without increasing side effects compared to other biologic therapies like Humira.
What conditions is Cimzia approved to treat?
Cimzia is approved for the treatment of several autoimmune disorders including:
- Crohn's disease (adults with moderate to severe cases)
- Rheumatoid arthritis (in combination with another drug, methotrexate)
- Psoriatic arthritis
- Moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
- Ankylosing spondylitis (also known as spinal arthritis)
How does Cimzia help with these illnesses?
Cimzia and Humira are both used to manage autoimmune conditions by decreasing the amount of tumor necrosis factor alpha (TNF-alpha) in the body. TNF-alpha is a protein produced by white blood cells that plays a key role in promoting inflammation, which can be harmful when it's overproduced or activated for extended periods as seen in various autoimmune diseases. Both Cimzia and Humira work by binding to TNF-alpha, preventing it from interacting with its receptors on cell surfaces, thus reducing inflammatory responses.
However, while they share similar mechanisms of action, there are differences between these two medications. For instance, Cimzia is PEGylated - meaning it has been chemically attached to polyethylene glycol molecules - which increases its half-life and decreases how often injections need to be administered. On the other hand, Humira needs more frequent dosing but has established efficacy backed up by years of clinical data across different patient populations.
What is Humira?
Humira is a brand name for adalimumab, which is a tumor necrosis factor (TNF) inhibitor. This means it works by binding to TNF-alpha and blocking its interaction with the p55 and p75 cell surface TNF receptors. It was first approved by the FDA in 2002. Adalimumab does not prevent or treat infections but instead blocks inflammation that can be caused by an overactive immune response in conditions like rheumatoid arthritis, psoriatic arthritis, Crohn's disease among others.
Unlike Cimzia (certolizumab pegol), Humira impacts both soluble form of TNF-alpha and transmembrane form of TNF-alpha due to its full-length antibody structure compared to Cimzia's PEGylated Fab' fragment of humanized monoclonal antibody structure. The effects on inflammatory diseases have been extensively studied leading to Humira being one of the best-selling drugs worldwide. Its side-effect profile includes common symptoms such as upper respiratory infections, headache, rash or nausea while serious side effects include tuberculosis or other severe infections.
What conditions is Humira approved to treat?
Humira is a medication that has been approved by the FDA for a wide range of conditions including:
- Rheumatoid Arthritis (RA)
- Psoriatic Arthritis
- Ankylosing Spondylitis
- Crohn's disease
- Ulcerative colitis In addition, Humira can also be used to treat moderate to severe chronic 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 plays a crucial role in the body's immune response to disease. Overproduction of TNF can lead to autoimmune disorders such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and Crohn's disease. Humira works by blocking the action of TNF, thereby reducing inflammation and other symptoms associated with these conditions. Its effect on inflammatory cytokines also contributes to its effectiveness as an immunosuppressive drug. While Cimzia has similar anti-TNF properties, Humira is often preferred due to its longer track record and wider range of approved uses. Furthermore, Humira may be prescribed when a patient does not respond well to typical first-line treatments or it may be combined with them for maximum effect.
How effective are both Cimzia and Humira?
Both certolizumab pegol (Cimzia) and adalimumab (Humira) are effective treatments for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease among other inflammatory conditions. They were both approved by the FDA within a few years of each other and act on similar biological pathways - primarily targeting tumor necrosis factor alpha (TNFα), a pro-inflammatory cytokine involved in various autoimmune diseases.
The efficacy of Cimzia and Humira was directly compared in several clinical trials; they exhibited comparable effectiveness in managing symptoms of these disorders as well as similar safety profiles. A 2016 study found no significant difference between patients receiving Cimzia or Humira in terms of symptom relief or side effects.
A 2015 review indicated that Cimzia is effective from the early stages of treatment with a favorable side effect profile compared to many other TNFα inhibitors. It's also well-tolerated across different patient demographics including elderly populations. The optimal dosing for most indications is usually about 400mg every month after initial loading doses.
On the other hand, a review conducted around the same time suggested that Humira appears more effective than placebo and equally efficacious when compared to other common TNFα inhibitors for treating inflammatory conditions such as rheumatoid arthritis and psoriasis. However, like Cimzia it's often considered only after traditional first-line treatments have failed due to its high cost and potential side effects despite being one of the most commonly prescribed biologics worldwide today.
In conclusion, both drugs offer potent anti-inflammatory action but their use may be determined by individual patient characteristics including co-existing health conditions, previous response to TNFα inhibitors among others factors.
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At what dose is Cimzia typically prescribed?
Dosages for both Cimzia and Humira vary depending on the condition being treated, but typically they are administered via subcutaneous injection. For rheumatoid arthritis, a usual dose of Cimzia is 200 mg every two weeks or 400 mg every four weeks. A common dosage regimen for Humira in treating rheumatoid arthritis involves an initial administration of 40 mg, followed by a 40-mg dose given every other week. Dosage may be increased to as high as once per week if there's no sufficient response after several weeks. The maximum dosage that should not be exceeded varies based on the patient's individual situation and condition being treated. Always follow your healthcare provider’s instructions.
At what dose is Humira typically prescribed?
Humira treatment typically begins 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). Following this, the dosage usually drops to 40 mg every other week. If there is no response to the treatment after about eight weeks, you may discuss increasing the frequency with your doctor - often up to once a week. However, it's crucial not to exceed this recommended dosage without medical supervision. The medication can be self-administered via injection under the skin (subcutaneously) and should ideally be spaced evenly over time.
What are the most common side effects for Cimzia?
The potential side effects of Cimzia and Humira are quite similar, as they both alter the immune system response. Here are some of the common side effects that you may experience:
- Risk of serious infections (such as TB, fungal, and viral infections)
- Fatigue or general weakness
- Headache
- Skin rash or itching
- Nausea or vomiting
- Abdominal pain
- Back pain
- Joint pain or swelling
- Diarrhea
More severe but less common side effects can include breathing difficulties, chest discomfort or palpitations, high blood pressure, night sweats and weight loss.
If any such symptoms occur while taking either medication it is important to seek prompt medical attention.
Are there any potential serious side effects for Cimzia?
Cimzia and Humira are both medications used to treat inflammatory conditions such as rheumatoid arthritis, but they can have different side effects:
- Signs of infections – Fever, sweats or chills, muscle aches, cough, shortness of breath, bloody phlegm, weight loss or warm/red/painful skin sores on your body. Both Cimzia and Humira can lower the ability of your immune system to fight infections.
- Allergic reactions – hives; difficulty breathing; swelling of your face, lips, tongue or throat. If you show any signs of an allergic reaction after taking either medication seek medical help immediately.
- Neurologic reactions - numbness or tingling in any part of your body; vision problems; dizziness; muscle weakness
- Heart failure including new worsening symptoms like shortness of breath or swelling in ankles
- Liver problems - feeling very tired; skin or eyes look yellowish (jaundice); poor appetite/vomiting
- Blood disorders - fever that doesn't go away; bruising/blood spots under the skin
Always contact a healthcare provider if you experience these symptons while taking either Cimzia or Humira.
What are the most common side effects for Humira?
Humira, a commonly prescribed medication for several chronic inflammatory conditions, can lead to the following side effects:
- Upper respiratory infections such as sinusitis and sore throat
- Headache
- Rash or itching
- Nausea and stomach pain
- Urinary tract infection
- High blood pressure (hypertension)
- Injection site reactions including redness, rash, swelling, itching or bruising.
More serious but less common side effects could include heart failure symptoms like shortness of breath or swelling of ankles. It's also crucial to note that Humira can potentially cause your body to produce fewer blood cells needed for clotting and fighting off infections leading to easy bleeding/bruising and frequent infections respectively. Always consult with your healthcare provider before starting any new medications.
Are there any potential serious side effects for Humira?
Humira, although commonly used for the treatment of several inflammatory conditions, can lead to some serious side effects in rare cases. These include:
- Signs of a severe allergic reaction such as skin rashes or hives, difficulty breathing or swallowing, swelling of your face and throat
- Nervous system problems like numbness or tingling, problems with vision, weakness in arms or legs
- New heart failure symptoms including shortness of breath while lying down; fatigue and weakness; irregular heartbeat
- Liver issues presented through jaundice (yellowing of your eyes), dark brown urine
- Unusual bleeding tendencies like prolonged bleeding from cuts, blood in stools or urine.
If you experience any signs of these potential complications while taking Humira it is important that you contact a healthcare professional immediately.
Contraindications for Cimzia and Humira?
Both Cimzia and Humira, along with most other TNF inhibitors used for treating autoimmune disorders, may cause an increase in symptoms or trigger new diseases. If you notice worsening symptoms or the development of new conditions such as neurological disorders, heart failure, blood disorders or certain types of cancers while taking these medications, please seek immediate medical attention.
Neither Cimzia nor Humira should be taken if you are currently being treated with any kind of biological therapy for your condition. Always inform your physician about all the medications that you are currently taking; biologics will require a period to clear from the system to prevent dangerous interactions with Cimzia and Humira.
Moreover, both drugs can potentially reactivate latent tuberculosis (TB) infection before starting either drug patients should be tested for TB. Immunizations should also be brought up to date prior to initiating treatment as live vaccines are contraindicated due to risk of causing infections.
How much do Cimzia and Humira cost?
For the brand name versions of these drugs:
- The price for two injections (1.2 ml each) of Cimzia is around $4,500 on average, which works out to about $75/day given that this medication is typically administered every two weeks.
- A pre-filled pen or syringe containing 40 mg of Humira costs about $5,600 and is usually taken every other week as well — translating into a daily cost around $95.
Thus, if you are comparing based on typical dosages and standard frequency for both medications, then brand-name Cimzia tends to be less expensive than Humira on a per-day treatment basis. However, it's important to note that cost should not be your primary concern when determining which drug is best for you.
As far as generic versions go:
Currently there are no biosimilar or generic equivalents available in the U.S market for either Cimzia (certolizumab pegol) or Humira (adalimumab). This means patients will need to pay the higher prices associated with these two biologic medications unless they have insurance coverage or qualify for patient assistance programs offered by pharmaceutical companies.
Popularity of Cimzia and Humira
Certolizumab pegol, available under the brand name Cimzia, was estimated to have been prescribed to about 100,000 people in the US in 2020. Certolizumab accounted for just over 3% of TNF inhibitor prescriptions in the US. The drug is unique as it is a PEGylated anti-TNF medication which may reduce immunogenicity and extend its half-life. Prescriptions for certolizumab have been generally increasing since its approval by FDA in 2008.
Adalimumab, including brand versions such as Humira, was prescribed to nearly 500,000 people in the USA in 2020. In the US alone, adalimumab accounts for approximately 50% of all TNF inhibitor prescriptions due to its wide array of indications including rheumatoid arthritis and psoriasis among others. Despite being on the market since early this century (2002), prescription rates remain steady with a slight increase noted over recent years.
Conclusion
Both Cimzia (certolizumab pegol) and Humira (adalimumab) are established treatments for multiple autoimmune conditions, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, and plaque psoriasis. Both medications operate by inhibiting the tumor necrosis factor-alpha (TNFα), a protein involved in systemic inflammation.
While both drugs work similarly to control inflammation and slow down disease progression, there are differences that might make one more suitable than the other depending on individual patient needs. For instance, Cimzia is shown to have less impact on certain immune responses compared to Humira which could be beneficial for patients at risk of infections.
Neither drug is available in generic form due to their complex biological nature; they also come with high costs that can put them out of reach for some patients without insurance coverage or assistance programs. The onset time varies between individuals but it typically takes several weeks before improvements become noticeable with these therapies.
The side effect profiles of both drugs are similar since they function through comparable pathways. Common adverse effects include injection site reactions and increased risk of infections due to immunosuppression caused by these medications. As always when initiating treatment with either Cimzia or Humira, patients should closely monitor their health status and seek medical help immediately if new symptoms arise or existing ones worsen.
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Refrences
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