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What is Humira?

Monday, October 19th, 2009

Humira is the brand name that was given to the TNF inhibitor adalimumab.  TNF stands for “tumor necrosis factor”.   Tumor necrosis factor is the part of the immune system that regulates swelling, which is one of the main symptoms of plaque psoriasis and psoriatic arthritis.

Adalimumad suppresses the immune system in a manner similar to etanercept (brand name Enbrel).  I wrote an article about Enbrel here.

One of the main differences between Enbrel and Humira is how they were created: Enbrel (etanercept) was created by fusing a protein and a human gene together while Humira (adalimumab) is made entirely from a human monoclonal antibody (as opposed to treated animal cells).

Humira is prescribed for moderate to severe plaque psoriasis, usually after all other available medications have proven to be ineffective.  It is also prescribed for psoriatic arthritis, which can severely limit a person’s ability to use their hands and other joints.

Adalimumad is a type of biologic, or a drug that was constructed to carry out a specific task within the human body (and nothing else).

Since Humira inhibits the immune system, anyone taking this drug runs the risk of contracting diseases, including tuberculosis.  The somewhat extreme risks that accompany this drug are a testament to how well it works for many people who are desperate for relief from their psoriasis symptoms.  Most people with moderate to severe psoriasis report dramatic improvements after taking Humira.

Ongoing Humira treatment must be administered via at-home injections, every other week.  The serum is prepackaged in either standard syringes or custom “Humira Injection Pens.”

The video below depicts a girl injecting herself in the stomach with one syringe-worth of Humira.  By my understanding, it must be injected into fatty tissue.

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How Does Pregnancy Affect Psoriasis?

Tuesday, October 6th, 2009

Consistent with the unpredictability that characterizes psoriasis in general, pregnancy may or may not improve your psoriasis.

The main difference between being pregnant or not is hormone levels.  There are a variety of theories about how pregnancy hormone levels might improve psoriasis, but this subject matter still remains relatively unexplored.  You may be able to come to your own conclusions based on these approximated trends:

  • 50% of pregnant women with psoriasis see their symptoms improve
  • 25% get worse
  • 25% stay the same

Most pregnant women with psoriasis see their condition improve during pregnancy and then worsen afterward.  Also, with multiple pregnancies, the psoriasis symptoms in question tend to be the same for each pregnancy (if the psoriasis improved during the first trimester last time, that will most likely happen again, etc.).

As a general rule, psoriasis does not affect a woman’s (or a man’s) reproductive ability nor does it pose a threat to the child after it is conceived.  Of course, it would be a good idea to let your obstetrician just in case.

An aspect of being pregnant with psoriasis that should be handled with care is the medications that you are taking to treat your psoriasis.  Many psoriasis medications can be extremely detrimental to your baby’s health, especially retinoids (relatives of Accutane).  Even regular supplements can be harmful to your baby, so this would be at the top of your obstetrician question list.  Mothers with psoriasis who plan on breastfeeding should also take every possible precaution since these medications can pass on to the baby.

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What is Enbrel (Etanercept) and Is It an Effective Psoriasis Treatment?

Thursday, October 1st, 2009

Enbrel (etanercept) helps to control the effects of Psoriasis by inhibiting the body’s immune system.  Specifically, Enbrel is a TNF-alpha inhibitor. TNF-alpha (tumor necrosis factor alpha), is a key player in making white blood cells rush to infected/injured areas of the body, thus creating inflammation. Thus, Enbrel helps to suppress much of the bothersome inflammation, which is a symptom of psoriasis.

Enbrel is a biologically engineered drug, or “biologic.” It is also an immunosuppressant.

Enbrel must be injected once or twice weekly, depending on the dosage.  Taking the drug orally is not an option because the digestion system would destroy it.  It usually comes in pre-prepared syringes.

People with plaque psoriasis and psoriatic arthritis report different degrees of improve as a result of taking Enbrel.  According to different online forums, for example, people with plaque psoriasis claim that their skin cleared up dramatically.  People with psoriatic arthritis claim to have gone from totally debilitated by pain to being able to move around, go outside, etc. Other people (the minority, it would seem) claim that their symptoms actually worsened and they’re overall quality of life become so much worse that they had to stop taking it.

Because Enbrel is a TNF-blocker it can open the body up to catching tuberculosis or it can awaken latent tuberculosis.  Side effects also include sepsis (which is actually a side effect of other infections) and a variety of other infections. Since the side effect of using immunosuppressants can vary so widely, it is important to keep in close contact with your dermatologist and immediately let them know about any negative developments.

As you might have guessed, Enbrel is available by prescription only.

Other TNF inhibitors that were released soon after Enbrel (after 1998) include Remicade (infliximab) and Humira (adalimumab), none of which have been as widely used as Enbrel.

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What Are Biologics (Biologic Drugs) and Are They an Effective Psoriasis Treatment?

Thursday, October 1st, 2009

Biologics are an up-and-coming class of drugs that are produced and designed via biological means.  That is to say, they are designed or isolated from living, natural sources to interact with the human body in specific ways.  Biologics are conceptualized out of what is known about cellular biology rather than the more common trial-and-error type of the development that has characterized pharmaceutical development for most of history. They seem to be the next big thing in drug treatments since, by my understanding, they attack diseases or any given health condition more directly, at the cellular level.

The psoriasis treatment Enbrel (etanercept) is a well known biologic designed to alter a specific aspect of human the immune system — TNF-receptors.  Etanercept is a genetically-engineered (custom-designed), synthetic protein designed to make the body forget about sending as many white blood cells to affected areas of the body, thus reducing inflammation.

Another biologic, Remicade (infliximab), is a close relative of Enbrel, as it also prevents TNF from creating excessive inflammation.  Both of these drugs inhibit TNF (which stands for tumour necrosis factor), though in different capacities, resulting in different psoriasis treatment results.  Both of Enbrel and Remicade drugs are selective immunosuppressants, which is to say, they inhibit the body’s immune system from wreaking as much havoc on the body as it might otherwise.

The goal here is to create treatments that isolate and bind the “bad” cells, or the ones that bring about undesirable side effects (such as the symptoms that characterize psoriasis).

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