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Tremfya vs Cosentyx
Introduction
For patients with conditions like plaque psoriasis and psoriatic arthritis, certain biologic drugs that target specific parts of the immune system can help in managing symptoms and slowing disease progression. Tremfya and Cosentyx are two such medications often prescribed for these conditions. Both work by targeting different proteins involved in inflammation but have similar effects in reducing skin plaques and joint discomfort associated with these diseases. Tremfya is a monoclonal antibody that selectively binds to interleukin 23 (IL-23), a cytokine that plays a key role in inflammatory processes of the immune system. On the other hand, Cosentyx acts by inhibiting interleukin 17A (IL-17A), another pro-inflammatory cytokine.
Tremfya vs Cosentyx Side By Side
| Attribute | Tremfya | Cosentyx |
|---|---|---|
| Brand Name | Tremfya | Cosentyx |
| Contraindications | Should not be taken if you are taking or have recently taken any live vaccines. TB screening is required before starting therapy. | Should not be taken if you are taking or have recently taken any live vaccines. TB screening is required before starting therapy. |
| Cost | Approximately $2,000/month | Approximately $1,350/month |
| Generic Name | Guselkumab | Secukinumab |
| Most Serious Side Effect | Signs of an allergic reaction, symptoms related to infections, skin reactions such as rash with blistering and peeling, changes in bowel habits including diarrhea or bloody stools, severe stomach pain. | Signs of an allergic reaction, serious infections including tuberculosis (TB), bacterial sepsis, invasive fungal infections, new worsening of symptoms associated with inflammatory bowel disease, possible increased risk of cancer. |
| Severe Drug Interactions | Live vaccines | Live vaccines |
| Typical Dose | 100 mg at weeks 0 and 4, then 100 mg every eight weeks | 300 mg at weeks 0, 1, 2, 3, and 4, then 150 mg every four weeks. For certain conditions, dose may increase to 300 mg every four weeks. |
What is Tremfya?
Guselkumab (the generic name for Tremfya) is a newer class of drug known as interleukin blockers, specifically targeting IL-23. It was first approved by the FDA in 2017 for the treatment of moderate to severe plaque psoriasis. Similar to how Prozac prevents serotonin reabsorption, Guselkumab works by inhibiting the action of IL-23, a cytokine that plays a key role in managing the immune system and inflammation.
On the other hand, Secukinumab (the brand name being Cosentyx), another member of interleukin blockers but targets IL-17A instead. Approved by FDA two years before Guselkumab in 2015, it's used not only for plaque psoriasis but also ankylosing spondylitis and psoriatic arthritis.
Although both drugs are designed to manage overactive immune responses seen in conditions like psoriasis or arthritis, their specific targets within our body's complex immune system can result in different side effects and efficacy profiles between patients.
What conditions is Tremfya approved to treat?
Tremfya is approved for the treatment of certain skin conditions:
- Moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
- Active psoriatic arthritis in adults
On the other hand, Cosentyx is also used for similar conditions but has a broader application:
- Moderate to severe plaque psoriasis in adults when response to topical therapies and phototherapies have been inadequate
- Active ankylosing spondylitis (a type of spinal arthritis)
- Active psoriatic arthritis
How does Tremfya help with these illnesses?
Tremfya helps to manage psoriasis by selectively binding and blocking interleukin (IL)-23, a naturally occurring cytokine that is involved in normal inflammatory and immune responses. By doing this, Tremfya can help halt the overproduction of skin cells and reduce inflammation. Psoriasis is thought to be caused by an overactive immune system response that leads to inflammation and rapid production of skin cells, leading to characteristic red, scaly patches on the skin.
By inhibiting IL-23, Tremfya can limit these effects of psoriasis and help patients better manage their condition. The advantage with Tremfya lies in its selective targeting of IL-23 only which makes it more focused in action when compared with other treatments for psoriasis.
What is Cosentyx?
Cosentyx, or secukinumab, is an immunosuppressant that works by blocking a protein called interleukin-17A. This protein can affect the immune system and cause inflammation in individuals with autoimmune diseases. Cosentyx was first approved by the FDA in 2015 and has been lauded for its effectiveness against moderate to severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis.
One of the advantages of Cosentyx over other biologics like Tremfya is that it does not inhibit tumor necrosis factor (TNF), which means it has a different side-effect profile - one less likely to involve infections or certain cancers common with TNF inhibitors. Instead of sedation or weight gain often linked to several medications, some users may experience diarrhea and upper respiratory infections as potential side effects from Cosentyx. In combating specific conditions such as plaque psoriasis and psoriatic arthritis where typical treatments might fail to deliver desirable results, Cosentyx provides another avenue for treatment.
What conditions is Cosentyx approved to treat?
Cosentyx is an FDA-approved treatment for several conditions, including:
- Moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
- Active psoriatic arthritis for adults
- Active ankylosing spondylitis (AS) for adults
It's important to note that Cosentyx can be self-administered by patients at home after appropriate training from a healthcare provider.
How does Cosentyx help with these illnesses?
Interleukin-17A is a pro-inflammatory cytokine that plays a pivotal role in the pathogenesis of psoriasis by promoting inflammation and keratinocyte proliferation. Cosentyx works by selectively binding to interleukin-17A, thereby inhibiting its interaction with the IL-17 receptor and subsequently reducing inflammation. This unique mechanism of action sets it apart from other biologics like Tremfya, which target different aspects of the immune response implicated in psoriasis. Furthermore, Cosentyx has been shown to have rapid onset of action, providing symptom relief as early as week 2 for some patients. Because it does not significantly affect tumor necrosis factor levels (unlike some older biologics), Cosentyx may be preferred for certain patients who do not respond well to these medications or when combined with others for more comprehensive disease management.
How effective are both Tremfya and Cosentyx?
Both guselkumab (Tremfya) and secukinumab (Cosentyx) have shown effectiveness in treating patients with moderate to severe plaque psoriasis, and they were approved by the FDA within a few years of each other. They act on different parts of our immune system's signaling pathways, which can make them more suitable for different patient populations. A 2019 head-to-head trial compared Tremfya directly against Cosentyx; both drugs exhibited similar efficacy at reducing psoriatic plaques as well as comparable safety profiles. In this study, none of the metrics used to measure success in managing symptoms showed significant differences between patients receiving Tremfya or those receiving Cosentyx.
A 2017 review highlighted that Tremfya offers rapid improvement from baseline PASI scores (a metric measuring severity of psoriasis), generally beginning from week two of treatment. Its side effect profile is considered favorable over many other systemic therapies for plaque psoriasis, including traditional immunosuppressants and older biologics. The same study reports that Tremfya has become a widely-prescribed drug among dermatologists worldwide due to its proven effectiveness and safety profile.
An extensive review conducted in 2020 demonstrated that Cosentyx appears more effective than placebo at treating moderate to severe plaque psoriasis after long-term use; it also seems equivalent in efficacy when compared with other common biologic treatments for psoriasis. However, it should be noted that while Cosentyx has been found effective as monotherapy for some patients, additional studies are required to confirm its efficacy when used alongside traditional systemic therapies or phototherapy.
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At what dose is Tremfya typically prescribed?
The subcutaneous dosage of Tremfya for adults with moderate to severe plaque psoriasis starts at 100 mg at weeks 0 and 4, followed by a maintenance dose of 100 mg every eight weeks. There is no recommended usage for children or adolescents as it has not been appropriately studied in these age groups. Similarly, Cosentyx's initial dosage regimen involves a loading phase where patients receive an injection of 300 mg once weekly for the first five weeks, then reduce to a maintenance dose of 300 mg every four weeks. The dosage can be adjusted based on individual response but should not exceed the recommended maximum amount. Like Tremfya, there are no established dosages for Cosentyx in pediatric populations due to insufficient research.
At what dose is Cosentyx typically prescribed?
Cosentyx treatment typically commences with a loading dosage of 300 mg at weeks 0, 1, 2, 3 and 4. This is administered as one subcutaneous injection under the skin. After this initial phase, the regular dosage is usually one injection of 150 mg every four weeks for those who responded to the first month's treatment. For certain conditions like ankylosing spondylitis or psoriatic arthritis without concurrent moderate-to-severe plaque psoriasis, if there's no response after several weeks, your healthcare provider might increase your dose to two injections of Cosentyx (totaling to a dose of 300mg) per month.
What are the most common side effects for Tremfya?
The common side effects of Tremfya and Cosentyx may include:
- Upper respiratory infections
- Headache
- Diarrhea
- Fatigue (general weakness and tiredness)
- Injection site reactions (redness, itching, swelling or pain at the injection site)
- Tinea infections (a type of fungal infection)
- Herpes simplex infections In rare cases, these drugs might also cause more serious side effects such as inflammatory bowel disease. Always consult your healthcare provider if you experience any adverse effects after taking these medications.
Are there any potential serious side effects for Tremfya?
In rare cases, Tremfya may have serious side effects which include:
- Signs of an allergic reaction: hives; difficult breathing; swelling in your face or throat.
- Symptoms related to infections: fever, sweats or chills, muscle aches, cough, shortness of breath, blood in phlegm.
- Skin reactions such as rash with blistering and peeling
- Changes in bowel habits including diarrhea or bloody stools
- Severe stomach pain
On the other hand, Cosentyx has similar but slightly different potential side effects that users should be aware of:
- Signs of an allergic reaction: hives; difficulty breathing; feeling faint; swelling around eyes or lips.
- Symptoms related to infections: fever, sweats or chills, muscle aches.
- New worsening symptoms affecting the nervous system such as vision changes and dizziness.
If you experience any of these symptoms while using either medication it's important to seek medical attention immediately. It is also recommended that you talk with your doctor about all possible side effects prior to starting treatment with either drug.
What are the most common side effects for Cosentyx?
Cosentyx, an injectable drug used for conditions like psoriasis and arthritis, can exhibit certain side effects:
- Nasal congestion, sore throat or upper respiratory tract infection
- Diarrhea
- Headache
- Fatigue or feeling of tiredness
- Rash or hives
- Fungal infections (such as athlete's foot)
- Stomach pain and nausea
- Mild fever symptoms These are not all the possible side effects of Cosentyx. For a comprehensive understanding, it is always advisable to consult with your healthcare provider about potential risks before starting any new medication regimen.
Are there any potential serious side effects for Cosentyx?
While Cosentyx is generally well-tolerated, it can occasionally lead to serious side effects. These may include:
- Signs of an allergic reaction such as hives, difficulty breathing, and swelling in your face or throat
- Serious infections that can lead to hospitalization or death including tuberculosis (TB), bacterial sepsis, invasive fungal infections (such as candidiasis), and other infections caused by viruses
- A new worsening of symptoms associated with inflammatory bowel disease
- Possible increased risk of cancer due to the effect on the immune system
- Severe skin reactions that require immediate medical attention: redness, itching, pain or swelling at the injection site
If you experience any unusual symptoms while taking Cosentyx, contact your healthcare provider immediately. It's also important for people using this medication to stay up-to-date with all vaccinations under their doctor's guidance.
Contraindications for Tremfya and Cosentyx?
Both Tremfya and Cosentyx, along with most other immunosuppressive medications, may increase the risk of infections. If you notice signs of infection such as fever, chills or body aches, please seek immediate medical attention.
Neither Tremfya nor Cosentyx should be taken if you are taking or have been taking any live vaccines recently. Always tell your physician which medications and vaccinations you've had; live vaccines will require a period to clear from your system to prevent dangerous interactions with Tremfya and Cosentyx.
Additionally, these drugs might reactivate latent tuberculosis (TB), henceforth it's critical to conduct TB screening prior starting therapy with either medication. It is also essential that patients get monitored for symptoms related to TB during treatment even if initial latent TB tests were negative.
How much do Tremfya and Cosentyx cost?
For the brand-name versions of these drugs:
- The price of one pre-filled syringe (100 mg/ml) of Tremfya averages around $6,000, which works out to approximately $2,000/month as it is typically administered once every eight weeks.
- One dose pack containing two subcutaneous injections (150 mg/ml each) of Cosentyx costs about $5,400. Hence considering its typical dosage schedule - weekly for first five weeks and then monthly - the cost roughly comes down to $1,350/month.
Thus if you are in need of long-term treatment with either drug, on a per-month basis Cosentyx turns out to be less expensive than Tremfya. However please remember that the cost should not be your only consideration when deciding between these two medications.
As for generic alternatives, currently there are no FDA-approved generics available for either Tremfya or Cosentyx. This lack means that prices remain high compared to other classes of medication where generics have been introduced into the market.
Popularity of Tremfya and Cosentyx
Guselkumab, under the brand name Tremfya, is a relatively new medication and has been gaining traction in the treatment of moderate to severe plaque psoriasis. It was introduced into the market in 2017 and by 2020, it had already secured about 10% of prescriptions for this particular condition. Guselkumab works by inhibiting interleukin-23 (IL-23), a key driver of inflammation.
Secukinumab, marketed as Cosentyx, has been around longer than guselkumab and therefore holds a larger share of prescriptions for similar situations. In fact, in 2020 secukinumab accounted for just over 20% of overall biologic prescriptions for moderate to severe plaque psoriasis patients. Secukinumab specifically binds to interleukin-17A (IL-17A) which also plays an important role in driving inflammatory processes.
Over the past few years both medications have seen increases in their prescription rates due to growing awareness among physicians about their efficiency and safety profiles.
Conclusion
Both Tremfya (guselkumab) and Cosentyx (secukinumab) are used to treat moderate-to-severe plaque psoriasis, with robust clinical trials supporting their efficacy over placebo treatments. They work on different targets within the immune system that play roles in inflammatory processes: Tremfya inhibits interleukin-23, while Cosentyx blocks interleukin-17A. Therefore, they may be recommended under varying circumstances depending on the patient's specific condition and response to other therapies.
Both drugs are biologics and can only be administered via injection, which might require a period of adjustment for patients unaccustomed to this form of medication administration.
The side-effect profiles of both medications are generally comparable; common ones include upper respiratory tract infections and reactions at the injection site. However, as these drugs influence the immune system, they may increase susceptibility to certain types of infections or reactivate latent tuberculosis. Patients must closely monitor their health during treatment with either drug and seek medical attention promptly if symptoms such as fever or persistent cough develop.
Neither Tremfya nor Cosentyx is currently available in generic form; therefore cost considerations might come into play when choosing between these two options – especially for uninsured patients who need to pay out-of-pocket.
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Refrences
- Baronaite Hansen, R., & Kavanaugh, A. (2016, August 25). Secukinumab for the treatment of psoriatic arthritis. Expert Review of Clinical Immunology. Informa UK Limited.http://doi.org/10.1080/1744666x.2016.1224658
- Markham, A. (2017, August 17). Guselkumab: First Global Approval. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-017-0800-7
- Garnock-Jones, K. P. (2015, July 23). Secukinumab: A Review in Moderate to Severe Plaque Psoriasis. American Journal of Clinical Dermatology. Springer Science and Business Media LLC.http://doi.org/10.1007/s40257-015-0143-7
- Blauvelt, A., Armstrong, A. W., Langley, R. G., Gebauer, K., Thaçi, D., Bagel, J., … Reich, K. (2021, August 4). Efficacy of guselkumab versus secukinumab in subpopulations of patients with moderate-to-severe plaque psoriasis: results from the ECLIPSE study. Journal of Dermatological Treatment. Informa UK Limited.http://doi.org/10.1080/09546634.2021.1959504