Treating Psoriatic Arthritis with Biologic Drugs
Biologics, such as Enbrel, Humira and Remicade, are also considered disease-modifying antirheumatic drugs (DMARDs), which means they attempt to slow or stop the processes in the body that cause joint damage. They target a cytokine, or protein, called tumor necrosis alpha-factor (TNF-alpha) that causes psoriasis and psoriatic arthritis.
The drug Enbrel (also know by its generic name etanercept) is a TNF-alpha inhibitor that was approved for people with moderate to severe psoriatic arthritis in January 2002 and for psoriasis in April 2004. It also is approved for treating rheumatoid arthritis, ankylosing spondylitis and juvenile idiopathic arthritis.
Studies have shown that Enbrel reduced the progression of joint damage for two years among individuals with psoriatic arthritis. Treatment consists of once- or twice-weekly self-injections under the skin. The recommended dose for adults with psoriatic arthritis is 50 mg per week.
Humira (also know by its generic name adalimumab) is a TNF-alpha inhibitor approved by the FDA in October 2005 to treat psoriatic arthritis and in January 2008 to treat psoriasis. It is also approved to treat rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis and Crohn's desease.
The recommended dose for adults is 40 milligrams (mg) every other week. The drug is injected under the skin by the individual.
Remicade (also known by its generic name infliximab) was approved by the FDA in May 2005 to treat psoriatic arthritis and in September 2006 to treat psoriasis. It is also approved for ankylosing spondylitis, ulcerative colitis, rheumatoid arthritis and Crohn's disease.
During the first six weeks of treating psoriatic arthritis with Remicade, individuals receive 5 mg of the drug per kilogram (kg) of body weight in three infusions in a doctor's office. After the first three treatments, individuals continue to receive Remicade infusions at regular intervals of eight weeks. Similar to Enbrel and Humira, Remicade is an anti-TNF-alpha drug.
Simponi (also known by its generic name golimumab) was approved by the FDA in April 2009 to treat adults with moderate to severe psoriatic arthritis. It is also approved for rheumatoid arthritis and ankylosing spondylitis.
Patients take Simponi by giving themselves an injection under the skin. The recommended dose for patients with psoriatic arthritis is 50 mg once a month. Simponi also is a TNF-alpha inhibitor. Simponi is designed to be taken continuously to maintain improvement.
Stelara (also known by its generic name ustekinumab) was approved by the FDA in September 2009 for the treatment of moderate to severe plaque psoriasis. In September 2013 the FDA also approved Stelara to treat adults with psoriatic arthritis.
Stelara is given by injection under the skin at week 0 (the first week of treatment) and week 4, and then every 12 weeks afterwards. The recommended starting dose is 45 mg for individuals weighing 220 lbs or less, and 90 mg for those who weigh more than 220 lbs.