December 19, 2014
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Psoriatic Arthritis (PsA)

 Health Home >> Psoriatic Arthritis (PsA) >> Treating PsA and taking control 


Biologics

Biologics are used to slow the progression of joint destruction and the associated symptoms of psoriatic arthritis (PsA).  Biologics are often used when other disease-modifying anti-rheumatic drugs (DMARDs) fail to provide an adequate benefit or response. 

Some biologics (e.g., Humira®, Enbrel®, Simponi®) are given at home and are self-injected under the skin (into the fat of your leg or abdomen) much like insulin is for people with diabetes. Other biologics (e.g., Remicade®) are given as an injection into a vein (intravenous (IV) infusion) in a hospital or clinic setting over a period of time.

Biologics used in Canada for PsA include:

Adalimumab (Humira®)

  • What does it do? Adalimumab is used to reduce symptoms, slow the progression of joint damage, and improve physical function in adults with PsA. It can be used in combination with methotrexate for people whose PsA does not respond to methotrexate alone.
  • How do I use it? Adalimumab is given as an injection under the skin every other week using a prefilled pen or a prefilled syringe. You can learn to give yourself the injection at home (or have a friend or family member give the injection to you).

Etanercept (Enbrel®)

  • What does it do? Etanercept is used to reduce symptoms, slow the progression of joint damage, and improve physical function in adults with PsA. It can be used in combination with methotrexate for people whose PsA does not respond to methotrexate alone.
  • How do I use it? Etanercept is given as an injection under the skin once or twice a week using a prefilled syringe or a prefilled auto-injector. You can learn to give yourself the injection at home (or have a friend or family member give the injection to you).

Golimumab (Simponi®)

  • What does it do? Golimumab is used to reduce signs and symptoms in adults with PsA. It can be used alone or in combination with methotrexate for people whose PsA does not respond to methotrexate alone.
  • How do I use it? Golimumab is given as an injection under the skin once a month using a prefilled syringe or a prefilled auto-injector. You can learn to give yourself the injection at home (or have a friend or family member give the injection to you).

Infliximab (Remicade®)

  • What does it do? Infliximab is used to reduce symptoms, slow the progression of joint damage, and improve physical function in adults with PsA.
  • How do I use it? Infliximab is given as an injection into a vein over at least 2 hours (intravenous (IV) infusion). The injection is given in a hospital or clinic setting (sometimes called an infusion clinic). Doses are given at 0, 2, and 6 weeks, and then every 8 weeks.

These biologics work by blocking the effects of a chemical called tumour necrosis factor alpha (TNF-α).People with PsA have too much TNF-α in their bodies, which can lead to inflammation of the joints and surrounding tissues - causing joint pain, tenderness, and swelling.

The most common side effects of biologics include nausea, abdominal pain, rash, headaches, upper respiratory infections (e.g., bronchitis, cold, sore throat), and injection-site-related reactions (pain, itching, swelling). Reactions associated with infusion are uncommon and usually mild; infrequently, they can cause breathing difficulties, low blood pressure, and chest pain, which may require slowing or stopping the infusion.

Certain types of rare but important infections known as opportunistic infections are more likely to occur in people using biologics to treat PsA. Tuberculosis is an example of an opportunistic infection. For this reason, people starting treatment with biologics for PsA may be asked to have skin testing for tuberculosis.

Other serious side effects include severe allergic reactions, blood problems (e.g., decreased number of blood cells), and nervous system disease (with symptoms including numbness, tingling, and vision problems).

Your doctor may recommend regular blood tests and checkups while you are taking biologics. Ask your doctor what side effects you should watch out for and which need to be reported to your doctor.

Your doctor can help you choose the medication that is best for you. Once you start taking a medication, it is important to continue the dosing schedule recommended by your doctor. Early treatment is recommended to help bring PsA under control. Without continued treatment, these biologics may not work as effectively to help prevent joint damage.

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