What Is Psoriatic Arthritis
Psoriatic arthritis is a chronic inflammatory disease that affects about 30% of people who already have psoriasis, a chronic skin disease. It occurs when your immune system mistakenly starts attacking healthy joints and skin. The faulty immune response causes inflammation that can trigger joint pain, stiffness and swelling, as well as red, scaly skin patches called plaques.
How Is Humira Given
Humira is injected under your skin. You may receive your first dose of Humira in a doctors office or clinic. After that, you may be able to give yourself Humira injections at home.
Humira is injected into your thigh or abdomen . Make sure to rotate where you inject the drug with each use. This will help lower your risk for pain, redness, or swelling after the drug is injected. You shouldnt inject the drug into areas of your skin that are bruised, hard, red, or tender.
If youre going to be using Humira at home, your doctor or pharmacist will show you how to give yourself Humira injections. You can also visit the drug manufacturers website or read the prescribing information for step-by-step instructions.
Dont use more Humira than your doctor prescribes. Using more than this can lead to serious side effects.
Effectiveness Of Adalimumab For The Treatment Of Psoriatic Arthritis: An Italian Real
Background: Few studies have evaluated the effectiveness of adalimumab in the real-life setting in psoriatic arthritis .
Objective: To evaluate the 2-year retention rate of adalimumab in PsA patients. Potential baseline parameters influencing persistence on treatment were also evaluated.
Methods: PsA patients from 16 Italian Rheumatology Units treated with adalimumab as first- or second-line biological therapy were retrospectively evaluated. Adalimumab retention rate was evaluated at 12 and 24 months. Logistic regression was used to evaluate the association between predictor variables and adalimumab retention rate.
Results: From 424 patients who started treatment with adalimumab, 367 maintained treatment for 12 months and 313 for 2 years. At 24-months, Disease Activity in PsA remission and Low Disease Activity were achieved in 22.8% and 44.4% of patients, respectively. Adalimumab treatment significantly decreased the number of tender and swollen joints , DAPSA , PASI and CRP . Among a range of laboratory and clinical variables, only female gender was associated with improved adalimumab persistence at 24 months .
Independent of a range of predictor variables, adalimumab was shown to be effective, while maintaining a high retention rate after 2 years in PsA patients.
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Humira Drug Class And Form
Humira contains the active drug adalimumab, which is a biologic medication. Biologics are medications made from living cells. Adalimumab belongs to a class of medications known as tumor necrosis factor blockers. TNF is a protein made by your body.
Humira comes in three forms: a single-dose pen, a single-dose prefilled syringe, and a single-dose vial of liquid solution. To learn the strengths of the forms, see the Humira dosage section below.
The drug is given as an injection just under your skin . A healthcare provider can give you Humira injections. But you may be able to give yourself injections at home with the pen or syringe if your doctor approves. Youd need to be trained first. The vial form of Humira can be used only by healthcare providers. You wont be able to use vials yourself.
Humira Helped Stop The Progression Of Joint Damage
at Week 48 vs placebo at Week 24 in patients with active PsA who had an inadequate response to NSAIDs.1 HUMIRA also achieved greater improvement from baseline in HAQ-DI scores vs placebo at Week 12 .2
HAQ-DI=Health Assessment Questionnaire Disability Index mTSS=modified total Sharp score NSAIDs=nonsteroidal anti-inflammatory drugs
Hear Tims PsA Story
Tim looked forward to fishing with his two sons. When attaching lures became a struggle, HUMIRA helped with his pain, stiffness, swelling, and skin plaques. Hear how.
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Patients And Study Design
The present retrospective non-interventional longitudinal study included consecutive PsA patients who started a treatment with adalimumab as of 1st January 2013 in 16 Italian Rheumatology Centres. Inclusion criteria were the following: age 18 years diagnosed with active PsA and having started a treatment with adalimumab in routine clinical practice, regardless of whether they were biologic naïve or whether they had previously received biologic treatment. Active PsA was defined by a rheumatologist based on clinical judgment considered peripheral arthritis, enthesitis or axial involvement. Diagnosis of PsA was clinical and in addition, all patients satisfied CASPAR criteria for the classification of PsA . Patients’ written consent were obtained according to the Declaration of Helsinki when patients were first entered into the database for treatment. Ethics committee approval from all participating centres and written informed consent for the anonymous use of personal data were obtained from every patient, in compliance with the Italian Legislative Decree 196/2003.
How Do Biologics Treat Psoriatic Arthritis
Biologics are drugs that have specific targets in the body. They are proteins made in a lab from living cells. The living cells can come from a variety of sources. Some are human. Others come from animals like mice. Biologics can also come from mixed sources. When the types of living cells are mixed, the result is a chimeric biologic.
In PsA, biologics target specific parts of the immune system. Some target cytokines. These include tumor necrosis factor-alpha , interleukin 17 or interleukin 23 . Cytokines are proteins that play a role in the inflammatory response. When they are blocked, inflammation may be slowed or stopped. This is helpful for autoimmune or inflammatory conditions like PsA. Decreasing inflammation can help improve symptoms and prevent further joint damage.
Other biologics target T cells and block their activation. T cells are immune system cells that also play a role in inflammation. Biologics can also be used for other inflammatory conditions. This includes rheumatoid arthritis, plaque psoriasis, and ankylosing spondylitis.1-7
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What Drugs Interact With Cosentyx
Cosentyx may interact with warfarin, cyclosporine, or “live” vaccines. Tell your doctor all medications and supplements you use and all vaccines you recently received. Tell your doctor if you are pregnant or plan to become pregnant before using Cosentyx. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.
Who Can Take Biosimilars
All biologics, including biosmilars, are typically prescribed for people with more advanced disease, including individuals with moderate-to-severe psoriasis and active PsA. But each of the three approved biosimilars are indicated for different groups within this population.
You should not take biosimilars if:
- Your immune system is significantly compromised
- You have an active infection
Screening for tuberculosis or other infectious diseases is required before starting treatment with all biologics, including biosimilars.
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Before Taking This Medicine
You should not use Humira if you are allergic to adalimumab.
Before you start using this medicine , tell your doctor if you have signs of infection–fever, chills, sweats, muscle aches, tiredness, cough, bloody mucus, skin sores, diarrhea, burning when you urinate, or feeling constantly tired.
Humira should not be given to a child younger than 2 years old . Children using this medicine should be current on all childhood immunizations before starting treatment.
Tell your doctor if you have ever had:
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a chronic infection
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any numbness or tingling, or a nerve-muscle disorder such as multiple sclerosis or Guillain-Barre syndrome
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an allergy to latex rubber
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if you are scheduled to have major surgery or
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if you have recently received or are scheduled to receive any vaccine.
Tell your doctor where you live and if you have recently traveled or plan to travel. You may be exposed to infections that are common to certain areas of the world.
Humira may cause a rare type of lymphoma of the liver, spleen, and bone marrow that can be fatal. This has occurred mainly in teenagers and young men with Crohn’s disease or ulcerative colitis. However, anyone with an inflammatory autoimmune disorder may have a higher risk of lymphoma. Talk with your doctor about your own risk.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant. Make sure any doctor caring for your newborn baby knows if you used adalimumab while you were pregnant.
Youre Not Responding To Your Current Treatment Regimen
Theres no one-size-fits-all treatment for PsA. You might find that a biologic seems to work for a little while, but suddenly your symptoms get worse again. Switching biologic therapies is recommended for patients who experience treatment failure.
Your doctor will consider many factors before deciding which agent to switch you to. This includes your treatment history, disease characteristics, comorbidities, and other risk factors. Your doctor will also consider your health insurance coverage and out-of-pocket costs.
There are nearly a dozen different biologics now approved to treat PsA, and many more in the pipeline.
Approved biologics include:
- tumor necrosis factor -alpha inhibitors, such as certolizumab pegol , etanercept , adalimumab , infliximab , and golimumab
- interleukin -12/23 inhibitors, such as ustekinumab
- interleukin -17 inhibitors, such as secukinumab , ixekizumab , and brodalumab
- T-cell inhibitors, such as abatacept
- , such as tofacitinib
If one treatment fails, your doctor will carefully consider which biologic to switch you to. This is based on current treatment guidelines and recommendations.
Research shows that adalimumab and etanercept may not work as well if youve already tried a TNF-inhibitor. Ustekinumab and secukinumab, on the other hand, show better efficacy in patients who fail to respond to a TNF-inhibitor.
Keep in mind that it may take up to three months or more for a biologic to take full effect.
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Humira For Rheumatoid Arthritis
Humira is FDA-approved to treat moderate to severe rheumatoid arthritis thats active in adults. Active means that you have symptoms. The goal of Humira is to significantly ease signs and symptoms of RA and help limit joint damage and improve mobility.
RA is a chronic autoimmune disease that causes joint pain and inflammation throughout your body. Autoimmune means that your immune system mistakenly attacks your body. With RA, there are often periods of flare-ups, in which symptoms occur or get worse, and periods of remission, times when symptoms disappear.
Humira treats RA by blocking a protein called TNF. This decreases the activity of your immune system, leading to a reduction in the number and severity of RA symptoms.
Effectiveness for rheumatoid arthritis
Humira has been proven effective for treating RA in adults.
Clinical studies of people with RA compared Humira with a placebo. In some studies, people also took methotrexate with either Humira or a placebo. Researchers wanted to see how effective Humira was at helping people achieve a 20%, 50%, or 70% reduction in the severity and number RA symptoms. Across these studies, researchers found that Humira was more effective than the placebo.
In two studies, 12% to 21% of people who took Humira by itself or with methotrexate had a 70% reduction in the severity and number of RA symptoms after 6 months. This was compared with just 2% to 3% of people who took a placebo by itself or with methotrexate.
Pasi75 And Pasi90 Response Rates Through Week 10445
aLast observation carried forward analysis based on the duration of exposure to HUMIRA .PASI was assessed only for patients with at least 3% body surface area involvement at enrollment.
OLE Limitations
As with any longterm openlabel extension, there are several limitations with the OLE portion of this study. For example, there is the potential for enrichment of longterm data in the remaining patient population, as those who remain in the study generally fare better than those who discontinue.
ADEPT OLE study design intro: 285 patients from the ADEPT trial enrolled in the OLE at Week 24. All patients received HUMIRA 40 mg EOW.4
EOW=every other week NSAIDs=nonsteroidal anti-inflammatory drugs OLE=open-label extension PASI=Psoriasis Area and Severity Index RCT=randomized controlled trial
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Rapid And Sustained Improvement In Signs And Symptoms Through 2 Years4
aLast observation carried forward analysis based on the duration of exposure to HUMIRA .
Over 90% of RCT patients elected to enroll in the OLE.4
OLE Limitations
As with any longterm openlabel extension, there are several limitations with the OLE portion of this study. For example, there is the potential for enrichment of longterm data in the remaining patient population, as those who remain in the study generally fare better than those who discontinue.
ADEPT OLE study design intro: 285 patients from the ADEPT trial enrolled in the OLE at Week 24. All patients received HUMIRA 40 mg EOW.4
Expert Perspective on Improving Signs and Symptoms in PsA
Hear Dr. Mease talk about treating PsA signs and symptoms, including joint pain.
Humira And Other Medications
Below is a list of medications that can interact with Humira. This list doesnt contain all drugs that may interact with Humira.
Before taking Humira, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Humira and drugs that weaken your immune system
Taking Humira with certain medications that weaken your immune system can increase your risk for serious infections.*
Disease-modifying antirheumatic drugs
In people with rheumatoid arthritis , certain medications called disease-modifying antirheumatic drugs are often used to slow down the progress of RA and relieve symptoms. Some DMARDs are biologic drugs, like Humira. Biologics are medications made from living cells. These biologic DMARDs, when used together with Humira, can weaken your immune system. This makes you more likely to develop serious infections.
Using biologic DMARDs, such as abatacept and anakinra , isnt recommended when youre taking Humira.
However, its fine to take Humira with a DMARD called methotrexate , even if you have RA. According to Humiras manufacturer, these two drugs can be safely used together.
Tumor necrosis factor blockers
Examples of TNF blockers include:
- infliximab
- golimumab
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Will I Have Withdrawal Symptoms If I Stop Using Humira
Humira itself isnt likely to cause withdrawal symptoms. However, if you stop using Humira, theres a strong possibility that symptoms of your condition will return or worsen.
For example, in clinical studies, 22% of people with hidradenitis suppurativa who stopped taking Humira had a flare-up of their HS symptoms after they ended their treatment.
If you have questions about ending your use of Humira, talk with your doctor. You shouldnt stop taking the drug on your own.
Humira For Other Conditions
In addition to the uses listed above, Humira may be used off-label. Off-label drug use is when a drug thats approved for one use is used for a different one thats not approved. And you may wonder if Humira is used for certain other conditions. Below is information on other possible uses for Humira.
Humira for osteoarthritis
Humira isnt approved by the FDA for treating osteoarthritis, a type of arthritis. But the drug may be used off-label for the condition.
One study looked at 56 people with moderate to severe osteoarthritis of the knee. They were given an injection of either Humira or hyaluronic acid directly in their knee. Researchers found that people who received Humira reported more significant decreases in pain compared with people who received hyaluronic acid.
If youd like to learn more about using Humira for osteoarthritis, talk with your doctor. They can recommend the best treatments for you.
Humira for sarcoidosis
Sarcoidosis is a condition in which inflamed cells in your body build up in masses or nodules on various organs. It most commonly affects the lungs and lymph nodes.
Humira isnt FDA-approved to treat sarcoidosis. But the drug may be used off-label for the condition.
A systematic review looked at studies of TNF blocker drugs for treating different types of sarcoidosis. The review found that Humira may work to treat forms of sarcoidosis that affect the skin or eyes.
Humira for IBS
Humira isnt FDA-approved to treat IBS.
Humira for lupus
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Can I Stop Using Humira And Then Restart It Later
Yes. You can stop taking Humira and then restart your treatment later on. But the drug may not work as well the second time.
This is because its possible for your body to form antibodies against Humira. So when you stop and then restart your treatment, the antibodies can make the drug less effective.
However, one study looked at people with rheumatoid arthritis who stopped taking Humira, and then started their treatment again. These people had a flare-up after they ended their treatment. But taking Humira the second time was effective at easing the RA flare-up within 9 months in 100% of the people. Note that this was a small study, and further research is still needed.
Its important that you dont stop your Humira treatment without first checking with your doctor. They can help answer any questions you have.
Effectiveness For Plaque Psoriasis
Clinical studies have shown that Humira is effective for treating plaque psoriasis. These studies looked at adults with moderate to severe plaque psoriasis.
In one study, Humira was compared with a placebo . Among people who received 40 mg of Humira every other week, 71% reported that their psoriasis symptoms eased by at least 75%. This is in comparison with the placebo group, in which only 7% of people reported that their symptoms eased by 75% or more.
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Humira Complete Gives You The Resources You Need When You Need Them
With HUMIRA Complete, answers to your questions about HUMIRA, educational resources, and support are available for you when you need them.
Once enrolled, youll be connected with your own Nurse Ambassador, whose first priority is to get to know you personally to provide support along your treatment journey.
Plus, youll get connected to:
- The HUMIRA Complete Savings Card
- Help with injection training
- The Complete App to help you stay on track with your treatment plan
Nurse Ambassadors are provided by AbbVie and do not work under the direction of your health care professional or give medical advice. They are trained to direct patients to their HCP for treatment-related advice, including further referrals.