With nine biologic medications available to treat rheumatoid arthritis, it can be difficult knowing which to choose and how they compare.
Read my previous post - Biologic Medications for RA: The Big Picture - for a run-down of medications including Actemra, Cimzia, Simponi, Rituxan, Orencia, Humira, Kineret, Remicade and Enbrel.
Today, we're comparing Cimzia and Simponi which are medications FDA-approved last year for the treatment of moderate-to-severe rheumatoid arthritis.
CIMZIA (certolizumab pegol) and SIMPONI (golimumab ) are both monoclonal antibody therapies which block the action of tumor necrosis factor (TNF-alpha).
TNF-alpha is a substance in the body which contributes to inflammation.
Other anti-TNF therapies include Humira, Remicade, and Enbrel.
In addition to rheumatoid arthritis, these medications are approved for the treatment of other diseases.
CIMZIA is FDA-approved for the treatment of Crohn's disease, as are Humira and Remicade.
SIMPONI is FDA-approved for the treatment of ankylosing spondylisis and psoriatic arthritis, as are Humira, Remicade, and Enbrel.
All anti-TNF medications carry similar warnings as these drugs affect your immune system and lower its ability to fight infection.
Some people have serious infections while taking these drugs including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that spread throughout the body.
Some patients have died from these infections.
Please read the CIMZIA Medication Guide and the SIMPONI Medication Guide for further information.
CIMZIA and SIMPONI are self-injectable medications given by needle under the skin (subcutaneously) on the abdomen, thighs, or outer arms.
Humira, Kineret, and Enbrel are also subcutaneous self-injections.
CIMZIA and SIMPONI must each be stored in the refrigerator and allowed to reach room temperature (which takes about 30 minutes) before injection.
Used syringes must be disposed of in a puncture-resistant sharps container.
Check with the regulations in your county regarding the disposal of sharps containers.
The makers of CIMZIA collaborated with OXO Good Grips
® to design a prefilled syringe which would be easier-to-use for arthritic hands and fingers.
The syringe incorporates a large thumb pad, oversized plunger rod, nonslip finger grip, oval syringe barrel, and rounded finger loop for easy removal of the pull cap.
CIMZIA is also supplied as a lyophilized powder to be reconstituted in which case a healthcare professional would prepare and give you the injection.
The makers of SIMPONI offer medication in prefilled syringes or in a single-use SmartJectâ„¢ autoinjector device which has an easy-to-grip oval shape designed to fit comfortably in your hand.
With the SmartJectâ„¢ you never see a needle and after use must dispose of the entire device in a puncture-resistant sharps container.
Both pharmaceutical companies offer Nurse Support to answer any questions you may have about giving yourself injections.
SIMPONI is the first monthly self-injectable anti-TNF therapy approved to treat adults with rheumatoid arthritis.
Each prefilled syringe or SmartJectâ„¢ device contains a single dose of 50mg in a low volume of medication (0.5mL).
With CIMZIA, each prefilled syringe (or vial of powder) contains 200mg/mL of medication.
The recommended dose of CIMZIA for adult patients with RA is 400mg (given as two subcutaneous injections 200mg each) initially and at weeks two and four, followed by 200mg every other week.
For maintenance dosing, CIMZIA at 400mg injected every four weeks can be considered.
Please note that SIMPONI must be taken with methotrexate.
CIMZIA may be taken with or without certain other rheumatoid arthritis drugs (DMARDs) such as methotrexate.
Common side effects of SIMPONI include: upper respiratory tract infection, nausea, abnormal liver tests, redness at site of injection, high blood pressure, bronchitis, dizziness, sinus infection (sinusitis), flu, runny nose, fever, cold sores, and numbness or tingling.
Common side effects of CIMZIA include: upper respiratory tract infection, flu, cold, rash, urinary tract infections (bladder infections), or injection site reactions including redness, rash, swelling, itching or bruising.
Additional warnings for patients who use TNF-blocker medications include: reactivation of the hepatits B virus; new or worsening heart failure; nervous system problems such as multiple sclerosis; liver problems; low blood counts; new psoriasis or worsening of already present psoriasis; allergic reactions; or rarely symptoms of Lupus.
Are they effective?
Centocor Ortho Biotech (makers of SIMPONI) share that for some people, SIMPONI can start to relieve the signs and symptoms of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) in as little as four weeks from the start of therapy.
Results may not be the same for everyone.
SIMPONI has been extensively studied in clinical trials with more than 2200 people with RA, PsA, AS.
UCB, Inc. (makers of CIMZIA) share that in clinical trials CIMZIA has been shown to reduce rheumatoid arthritis pain, stiffness, and improve fatigue within one to two weeks in some patients.
Less than 2 percent of patients taking CIMZIA experienced injection site burning or stinging.
Many patients on CIMZIA experienced lasting relief at both six months and one year.
X-rays of patients with rheumatoid arthritis on CIMZIA show reduction of further joint damage at both six months and one year.
CIMZIA Cost and Support
A three-month supply of CIMZIA (three boxes including two syringes each) costs approximately $4700 retail at this time.
The CIMplicityâ„¢ support program offers verification of insurance coverage, financial support, and treatment and patient support.
The program is designed to expand access to treatment and will coordinate prescription coverage with your physician, insurance company, and pharmacy.
® Co-pay assistance program offers instant savings, up to $500 per pack on your CIMZIA prescription where allowed by law.
Additional assistance may be available for individuals who qualify, even if you do not have insurance coverage.
CIMplicityâ„¢ makes available a home health nurse to further educate you on your treatment, including how to administer CIMZIA, and a healthcare professional to answer any questions you may have about CIMZIA.
SIMPONI Cost and Support
A three-month supply of SIMPONI (three syringes) costs approximately $5000 retail at this time.
SimponiOneâ„¢ can help evaluate your insurance benefits, coverage, or out-of-pocket expenses and provide counseling regarding your eligibility for SimponiOne Cost Support or help identify other sources of financial support.
If you're eligible for SimponiOneâ„¢ Cost Support, you'll receive instant savings on your private insurance co-pay, deductible, and co-insurance medication costs for SIMPONI.
A full year program*:
Months one to six: No cost to you
Months seven to 12: You pay $5 a month"
*Subject to a $6,000 maximum program benefit, 12 months after activation, or 12 injections, whichever comes first.
" For every $1,005 portion of your out-of-pocket drug expenses.
SimponiOne Safe Returnsâ„¢ is a unique monthly service that lets you properly and easily dispose of used SmartJectâ„¢ autoinjectors and used prefilled syringes, right after you use them at no additional cost.
Estimated retail drug prices obtained at DrugStore.com.
If you have direct experience using either Cimzia or Simponi, please share in the comments section.
Click here to view a spreadsheet I created detailing and comparing the nine biologic medications prescribed for RA.