Compare Phototherapy and Biologics

Enbrel, Amevive, Humira		Versus	NB-UVB Phototherapy
Average PASI score is 49%. 29% of patients achieve 75% PASI score (IV).		Clearing at 12 Weeks	Average PASI score is 74% Typically 20-25 sessions to clear Long term remission for 90% of patients
Suppresses Immune System Linked to increased risk of cancer		Side Effects	Minimal Side Effects No increased risk of skin cancer
Not Fully Reimbursed Potentially high co-pays $12K-$18K every 6-12 months		Cost	Almost Always Reimbursed Small co-pays One-time reimbursable cost of home unit $800 up to $5K
12 IV, IM, or SC injection treatments per treatment cycle. Always in clinic		Ease of Use	Stand in front of light for seconds to minutes Can be done at home
Potential Cancer and Other Risks reported by drug companies, FDA, and Mayo Clinic among others		Safety	Decades of Safe Use

 

Biologics interfere with immune system functioning, linked to cancer

A normal immune system protects the body against disease by destroying bacteria, viruses, and other foreign proteins. Because biologic treatments act by interfering with the immune system, risks are raised for the following:

• Respiratory infection
• Flu-like systems
• Anemia
• Tuberculosis
• Cancer
• If you have HIV, worsen HIV symptoms and related complications

Safety information reported directly by drug manufacturers of biologics includes:

• Raptiva - Withdrawn in 2009 from US market due to safety.
• Enbrel - Serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis; and depression/personality disorder. Common side effects include: Injection site reactions, upper respiratory infections (sinus infections), and headache. Many of these infections occurred in patients predisposed to infections because of concomitant immunosuppressive therapy and/or their underlying disease. Rare cases of TB have been observed. See Enbrel.com safety information.
• Amevive - Commonly observed adverse events seen in the first course were: pharyngitis, dizziness, increased cough, nausea, pruritus, myalagia, chills, injection site pain, injection site inflammation and accidental injury. Serious adverse reactions include lymphophenia, increased risk of malignancies, serious infections requiring hospitalization, and hypersensitive allergic reactions, and hepatic injury. See Amevive Prescribing Information 2012.
• Humira - Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of unusual cancers in children, teenagers, and young adults using TNF blockers. Some people have developed a rare type of cancer called hepatosplenic T-cell lymphoma. This type of cancer often results in death. If using TNF blockers including HUMIRA, your chance of getting two types of skin cancer (basal cell and squamous cell) may increase. These types are generally not life-threatening if treated; tell your doctor if you have a bump or open sore that doesn't heal.
  
• FDA warned of cancer risk with Humira and Enbrel

Bibliography

• Amevive Product Prescribing Information 2012.
• Enbrel Product Safety Information 2012.
• Humira Product Safefy Information 2012.
• Raptiva. UPI news April 9, 2009.
• Al-Suwaiden MD, Sami. "Clearance is not a realistic expectation of psoriasis treatment ." Journal of the American Academy of Dermatology. Mar 2000 : 796-802.
• Windle, Mary. Understanding Psoriasis Medications, Systemic Age. 2003. Emedicine Consumer Health.
• Reviewed by Simon MD, Harvey. www.healthandage.com/html/well_connected/pdf/doc87. 10 Nov. 2003. Health and Age Centers.
• Shelk J. and Morgan P. Narrow-band UVB: a practical approach. 12 Dec. 2000. Dermatol Nursing..
• Herper, Matthew. J&J Edges Up On The Itch. 26 Mar. 2003. Forbes.com.
• Price, MD, Norman. An Overview of Psoriasis Therapy. 1998.

 

 

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