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Orencia vs Humira
Introduction
For patients dealing with autoimmune disorders such as rheumatoid arthritis or juvenile idiopathic arthritis, certain drugs that modulate the immune system can help in controlling inflammatory symptoms and slowing disease progression. Orencia and Humira are two such medications often prescribed for these conditions. They each target different components of the immune response but both have effects in reducing inflammation and joint damage. Orencia works by inhibiting T-cell activation, a crucial part of your body's immune response which when overactive can cause unwanted inflammation and tissue damage. On the other hand, Humira is classified as a TNF-alpha inhibitor; it binds to a protein called tumor necrosis factor alpha (TNFα), which plays a major role in causing inflammation in autoimmune diseases.
Orencia vs Humira Side By Side
| Attribute | Orencia | Humira |
|---|---|---|
| Brand Name | Orencia | Humira |
| Contraindications | Should not be taken with live vaccines; not recommended for use if there is an active infection without close monitoring by a doctor. | Should not be taken with live vaccines; not recommended for use if there is an active infection without close monitoring by a doctor. |
| Cost | Approximately $43-$50 per day | Approximately $178-$196 per day |
| Generic Name | Abatacept | Adalimumab |
| Most Serious Side Effect | Signs of an allergic reaction, symptoms of tuberculosis reactivation, signs of a blood disorder, heart problems, liver problems, neurological issues, new or worsening psoriasis symptoms. | Signs of an allergic reaction, signs of heart problems, any unexplained bruising or bleeding, feeling confused, severe nausea and vomiting, symptoms associated with tuberculosis, changes in vision. |
| Severe Drug Interactions | Live vaccines due to potential dangerous interactions. | Live vaccines due to potential dangerous interactions. |
| Typical Dose | 500–1000 mg intravenously at weeks 0, 2, and 4; then every four weeks thereafter. Alternatively, a subcutaneous injection of 125 mg weekly regardless of body weight. | Initial dose of 160 mg, then 40 mg every other week subcutaneously. Weekly dosing may be recommended depending on the condition and response. |
What is Orencia?
Abatacept (the generic name for Orencia) is a selective costimulation modulator that inhibits T cell activation, which hinders the progression of arthritis. It was first approved by the FDA in 2005. Orencia works to reduce inflammation and damage to joints by suppressing the immune response specifically targeting T cells. This makes it less likely to affect other aspects of your immune system than medications like adalimumab (Humira), which block an inflammatory protein called TNF-alpha and can have wider-ranging effects on your immune function.
Orencia has a more specific action with only minor influence on other parts of the immune system, leading to fewer side effects compared with drugs like Humira that have stronger effects on various aspects of immunity. However, both medications require careful monitoring due their effect on body's ability to fight infections.
What conditions is Orencia approved to treat?
Orencia is approved for the treatment of moderate to severe rheumatoid arthritis, juvenile idiopathic arthritis and adult psoriatic arthritis:
- Rheumatoid Arthritis in adults (as a monotherapy or with methotrexate)
- Juvenile Idiopathic Arthritis in children aged 2 years and older
- Adult Psoriatic Arthritis (in combination with another drug, such as methotrexate)
How does Orencia help with these illnesses?
Orencia works to control the symptoms of rheumatoid arthritis by inhibiting the activation of T-cells, a type of white blood cell that plays a key role in inflammation and joint damage. It does this by binding to a protein on the surface of these cells, thus blocking the chemical signal necessary for their full activation. T-cells are crucial components in body's immune response system and play a significant part in causing inflammation and joint damage associated with rheumatoid arthritis.
When overly active, they contribute to the excessive inflammatory response seen in conditions like rheumatoid arthritis. By interfering with this process, Orencia can reduce inflammation and help patients manage their condition more effectively.
What is Humira?
Humira, or adalimumab, is a potent drug used in the treatment of several autoimmune diseases. It belongs to a class of drugs known as TNF blockers. These medication work by reducing levels of tumor necrosis factor-alpha (TNF-α), an inflammatory substance that contributes to conditions like rheumatoid arthritis and psoriasis. Humira was first approved by the FDA in 2002.
Unlike Orencia which targets T-cells indirectly through modulating co-stimulatory signals, Humira directly inhibits TNF-α from interacting with its receptors on cell surfaces - thereby reducing inflammation caused by these diseases.
While it's not without side effects - including potential infections due to immune system suppression and occasionally injection site reactions - Humira has been proven effective for many patients who do not respond well to other traditional treatments for their condition.
What conditions is Humira approved to treat?
Humira has been given the green light by the FDA for the treatment of several autoimmune disorders, including:
- Rheumatoid arthritis
- Psoriatic arthritis
- Ankylosing spondylitis
- Crohn's disease
- Ulcerative colitis In addition to these conditions, Humira is also used to manage plaque psoriasis and juvenile idiopathic arthritis.
How does Humira help with these illnesses?
Tumor necrosis factor (TNF) is a substance in the body that can cause inflammation and lead to immune-system diseases, like rheumatoid arthritis or psoriasis. Humira works by blocking this TNF and thus reducing inflammation. It influences many processes in the body from pain perception to immune response regulation. Similar to how Wellbutrin operates on norepinephrine, Humira's influence on TNF alters bodily responses, specifically those related to autoimmune conditions. Its action does not significantly affect other inflammatory mediators unlike other biologics such as Orencia which targets T cells directly - another part of the immune system response chain - making it an option for patients who do not respond effectively to T cell modulators, or it may be combined with them for more comprehensive treatment strategies.
How effective are both Orencia and Humira?
Both abatacept (Orencia) and adalimumab (Humira) have shown significant effectiveness in managing rheumatoid arthritis, a chronic inflammatory disorder affecting the joints. Orencia was approved by the FDA in 2005, while Humira received approval just three years prior. Both drugs are designed to modulate the immune system but do so through different mechanisms.
Abatacept works by inhibiting T-cell activation - a key part of our immune response that can cause inflammation and damage when overactive in conditions like rheumatoid arthritis. Adalimumab, on the other hand, is an anti-TNF drug that blocks tumor necrosis factor-alpha (TNF-alpha), a pro-inflammatory substance produced by our bodies.
A head-to-head trial conducted in 2018 compared these two medications directly for their impact on rheumatoid arthritis symptoms. The results showed no significant difference between Orencia and Humira regarding efficacy or safety profile.
On another note, a systematic review from 2011 underscored Orencia's ability to reduce disease activity within the first month of treatment significantly. This study also highlighted its favorable side effect profile compared to other treatments for rheumatoid arthritis even among sensitive populations like elderly patients.
A meta-analysis published in 2016 indicated that adalimumab tends to be more effective than placebo at treating symptoms of moderate-to-severe rheumatoid arthritis with similar efficacy as other biological agents used for this condition. However, it is typically considered once methotrexate – a first-line therapy – fails or isn't tolerated well due to adverse effects. Adalimumab has been extensively studied both alone and alongside DMARDs such as methotrexate; hence there's robust data supporting its use as monotherapy or combination therapy for RA management. Despite some differences between them - mainly related to their mechanism of action - both Orencia and Humira may provide optimal relief for individuals who did not respond well or cannot tolerate conventional DMARDs due to adverse effects such as liver toxicity or bone marrow suppression.
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At what dose is Orencia typically prescribed?
Dosages for Orencia (abatacept) range from 500–1000 mg, based on body weight, administered intravenously at weeks 0, 2 and 4; then every four weeks thereafter. However, a subcutaneous injection of a fixed dose of 125 mg can be given weekly regardless of body weight. For Humira (adalimumab), the typical dosage is an initial subcutaneous injection of 80mg followed by 40mg every other week starting one week after the initial dose. Children's dosing will vary depending on their condition and weight; thus it should be determined by their healthcare provider. In both medications, if there is no response or symptom improvement after a certain period, your doctor may reconsider your treatment plan.
At what dose is Humira typically prescribed?
Humira treatment is typically initiated with a loading dose of 160 mg, which can be split into four doses over the course of one day or two consecutive days. Thereafter, a regular dosage of 40 mg every other week is administered subcutaneously (under the skin). In some instances, your healthcare provider may recommend weekly dosing depending on your response to therapy and specific condition being treated. It's important that Humira injections are spaced appropriately apart and should never exceed the prescribed amount within any given period without consulting with your doctor.
What are the most common side effects for Orencia?
Common side effects of Orencia can include:
- Headache
- Dizziness
- Sore throat, runny or stuffy nose (signs of an upper respiratory tract infection)
- Hypertension (high blood pressure)
- Nausea
- Rash
- Back pain and other body aches
- Fever and chills (flu-like symptoms)
On the other hand, Humira may cause side effects like:
- Infections such as sinusitis or pharyngitis.
- Injection site reactions including redness, rash, swelling, itching or bruising.
- Headache
-Nausea and abdominal pain.
-Raised liver enzymes indicating potential liver damage.
Remember to always consult with your healthcare provider if you experience these or any unexpected side effects while taking these medications.
Are there any potential serious side effects for Orencia?
While both Orencia and Humira are used to treat autoimmune disorders, they come with their own set of potential side effects:
- Signs of an allergic reaction: difficulty breathing, hives, swelling in your face or throat
- Symptoms of tuberculosis reactivation: persistent coughing, weight loss, fatigue
- Any signs of a blood disorder such as unusual bleeding or bruising
- Heart problems including chest pain, palpitations or irregular heartbeats; shortness of breath; swollen ankles
- Liver problems which can present as yellowing skin and eyes (jaundice), dark urine, severe nausea or vomiting
- Neurological issues like numbness/tingling/burning sensations; weakness in arms/legs; vision changes
- New or worsening psoriasis symptoms like red scaly patches or raised bumps filled with pus If you experience any severe symptom while taking either Orencia or Humira it is crucial that you seek medical attention immediately. Remember these are complex drugs affecting the immune system - always discuss potential risks and benefits thoroughly with your healthcare provider before making a treatment decision.
What are the most common side effects for Humira?
Humira, while a powerful medication for inflammatory conditions, can have its share of side effects:
- Headache or dizziness
- Rash or itching
- Stomach pain accompanied by nausea and potential vomiting
- Potential weight loss due to decreased appetite
- Muscle soreness or joint pain
- Sleep disturbances, ranging from difficulty falling asleep to insomnia
- Increased frequency of urination
- A rapid heartbeat that may be felt as palpitations
-Stuffy nose leading to sinus discomfort, dry mouth, and possible sore throat
-Anxiety symptoms including sweating and feeling nervous
-In rare cases confusion or agitation may occur.
Please remember it is always crucial to report any new symptom you experience while on Humira to your healthcare provider.
Are there any potential serious side effects for Humira?
Humira, like any other medication, can potentially cause serious side effects. If you are taking Humira and notice any of the following symptoms, seek immediate medical attention:
- Signs of an allergic reaction: rash; hives; itching; redness, swollen, blistered or peeling skin with or without fever; wheezing; tightness in the chest or throat; difficulty breathing or talking; unusual hoarseness; swelling of the mouth, face, lips, tongue or throat.
- Signs of heart problems: coughing up blood or vomit that looks like coffee grounds
- Any unexplained bruising or bleeding
- Feeling confused
- Severe nausea and vomiting
- Symptoms associated with tuberculosis (TB) such as a bad cough that lasts for three weeks or longer accompanied by weight loss
- Changes in vision including blurred vision
These are not all potential side effects. It is crucial to consult your healthcare provider about possible risks before starting treatment with Humira.
Contraindications for Orencia and Humira?
Both Orencia and Humira, as with most other immune system suppressing medications, may worsen symptoms in some people. If you notice your condition worsening or an increase in infections or allergic reactions, please seek immediate medical attention.
Neither Orencia nor Humira should be taken if you are taking, or have been taking live vaccines. Always inform your physician about all the medications and vaccines you are currently taking; live vaccines will require a period of about 6 weeks to clear from the system to prevent dangerous interactions with Orencia and Humira.
These drugs can also cause serious infections because they decrease the ability of your immune system to fight infections. You should not take these drugs if you have any kind of infection unless your doctor knows about it and is monitoring the situation closely.
How much do Orencia and Humira cost?
For the brand name versions of these drugs:
- The cost of Orencia (Abatacept) varies greatly based on the dosage and form. A single dose vial for injection (125 mg/1 ml) typically costs around $1,300 to $1,500, which equates to approximately $43-$50 per day when taken weekly as usually prescribed.
- Humira's pricing is also dependent on dosage and form. Typically, two pre-filled pens or syringes (40mg/0.8ml each), intended for bi-weekly use, can range from $5,000 to $5,500 in total price. This averages out roughly at about $178-$196/day.
Thus if you are using these medications as directed by your doctor — once a week for Orencia and every other week for Humira — then Orencia may be less expensive on a per-day treatment basis than Humira.
However it's important that cost should not be your primary consideration in determining which drug is right for you; efficacy and safety profiles matter more.
Currently there are no generic equivalents available for either Abatacept or Adalimumab (Humira’s active ingredient). Therefore prices remain high compared to medications with generic alternatives.
Popularity of Orencia and Humira
Abatacept, with its brand name Orencia, is a commonly prescribed drug for the treatment of rheumatoid arthritis. In 2020, it was estimated that about 130,000 people in the US were prescribed Orencia. Abatacept accounted for roughly 2% of prescriptions related to rheumatoid arthritis medications in the country. It has been consistently used by patients since its approval by the FDA back in 2005.
On the other hand, Adalimumab or more widely known as Humira is another medication utilized for treating similar conditions along with additional ones like psoriasis and Crohn's disease. In comparison to Orencia, Humira was prescribed to approximately 480,000 individuals in America during 2020 alone which shows a larger patient reach. This accounts for around just over 8% of overall prescriptions associated with rheumatoid and other autoimmune diseases treatments in the same year. The prevalence of adalimumab use has been on a steady rise ever since its introduction into medicinal practice from early-2003.
Conclusion
Both Orencia (abatacept) and Humira (adalimumab) have a proven track record of efficacy in patients with autoimmune diseases such as rheumatoid arthritis, backed by numerous clinical studies and meta-analyses indicating that they are more effective than placebo treatments. In some cases, the drugs may be combined, but this is subject to careful consideration by a physician due to potential interactions. Due to their different mechanisms of action - with Orencia inhibiting T-cell activation and Humira blocking TNF-alpha – they tend to be prescribed under different circumstances. For example, Humira might be considered as a first-line treatment for moderate-to-severe rheumatoid arthritis whereas Orencia can be used when other DMARDs fail or are not tolerated.
Both medications come at a high cost although biosimilar versions of adalimumab may provide some cost savings especially for patients who must pay out of pocket. Both Orencia and Humira require an adjustment period during which effects may not be noticeable right away.
In terms of side effects, both drugs share common ones such as upper respiratory infections or injection site reactions; however, there are differences too: while Humira carries slightly higher risks related to tuberculosis reactivation or fungal infections due its mechanism of action, Orencia has been associated less frequently with serious infections compared to other biologic agents like TNF inhibitors. For both drugs it’s crucial that patients report any new symptoms promptly since these could indicate potentially severe adverse events.
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Refrences
- Bang, L. M., & Keating, G. M. (2004). Adalimumab. BioDrugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00063030-200418020-00005
- Cvetkovi??, R. S., & Scott, L. J. (2006). Adalimumab. BioDrugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00063030-200620050-00005