Biologics and Biosimilars for Psoriatic Arthritis
Depending on the severity of your psoriatic arthritis, your doctor may prescribe a biologic to help you manage your symptoms.
Biologics are different from other medications because they are made up of genetically-engineered proteins derived from human genes. They can be given by injection or intravenous (IV) infusion. Each of the biologics works a little differently and targets specific parts of a patient’s immune system.
There are several types of biologics, including TNF inhibitors, Interleukin Blockers, and a few others. By targeting the main proteins that have been shown to cause psoriatic arthritis, these powerful drugs can help patients manage their disease more effectively.
Biologics aren’t just used for psoriatic arthritis and psoriasis; they also treat a variety of autoimmune diseases, such as rheumatoid arthritis, ulcerative colitis, and Crohn’s.
In addition to biologics, there are biosimilars now hitting the market. In a normal drug development cycle, drugs are on a patent for a certain amount of time. Once they’re off patent, other companies can create generic drugs using the active ingredients. However, it’s impossible to make generic versions of a biologic because they are derived from human genes. Because of this, companies are now developing drugs which are similar to the original biologic but do not use the exact same active ingredient—hence the term biosimilars.
For instance, Humira (adalimumab) is a TNF inhibitor which binds to TNF receptors. In 2016, adalimumab went off patent and competitors were allowed to come into the market. That year, Amjevita (adalimumab-atto) was the first biosimilar for Humira to be approved. The FDA has not approved it as a substitute for Humira, but the mechanism is similar. Since Amjevita (adalimumab-atto), Cyltezo (adalimumab-adbm) has also been approved as a biosimilar for Humira as well.
Each year, companies are researching and finding new ways to treat psoriatic arthritis. Just in the last few years, many more biologics were approved. The drug landscape is ever changing, with a few staple drugs remaining strong year in and year out.
The following biologics are currently approved for psoriatic arthritis:
Cimzia - This self-injectable tumor necrosis factor-alpha (TNF-alpha) biologic is made by UCB Pharma.
Cosentyx - This Novartis treatment is the first FDA-approved medication specifically targeted at IL-17A. It’s also the only medication in its class to be approved for psoriatic arthritis.
Enbrel - Created by Amgen, Enbrel is a self-injectable tumor necrosis factor-alpha (TNF-alpha) biologic.
Humira - Another self-injectable tumor necrosis factor-alpha (TNF-alpha), this biologic is manufactured by Abbvie.
Orencia - This Bristol-Myers Squibb T cell inhibitor biologic is available in both IV or self-injectable form.
Remicade - Janssen creates this tumor necrosis factor-alpha (TNF-alpha) which is given intravenously to patients.
Simponi - This tumor necrosis factor-alpha (TNF-alpha) biologic is given by self-injection and is created by Janssen.
Stelara - Stelara is an interleukin-12 (IL-12) and interleukin-23 (IL- 23) inhibitor, created by Janssen, and given by self-injection.
Could receive approval for psoriatic arthritis soon:
Xeljanz - Xeljanz is the first JAK inhibitor janus kinase inhibitor of its class and is created by Pfizer.
The following biosimilars are currently approved for psoriatic arthritis:
Inflectra - This Pfizer created product was created to be a biosimilar for Remicade.
Erelzi - Sandoz has created this biosimilar off of the biologic Enbrel.
Amjevita - Amjevita is Amgen’s response to the biologic Humira.
Renflexis - Working similarly to Remicade, Renflexis is created by Merck & Co.
Cyltezo - The first biosimilar from Boehringer Ingelheim, Cyltezo was created as a biosimilar to Humira.
Make sure to talk to your doctor to decide which biologic is right for you. You may have to try a few different treatments to find the one that works for you.