Competition

Question 1

Otzela

Answer 1

Small molecule inhibitor of PDE4

Generic Name: Apremilast
Dosing: twice daily 30mg oral tablet after 5 day medication start pack
Adverse Events: diarrhea, headache, nausea, depression, weight loss
Efficacy: PASI75 at week 16 33.1%

Question 2

Enbrel

Answer 2

TNF inhibitor

Generic Name: Etanercept
Dosing: self injection, starting dose 50mg twice weekly for 3mos, then once weekly
Adverse Events: injection site reaction, upper respiratory infection. Carries a black box warning for increased risk of infections
Efficacy: PASI75 at 3mos 47%
Black Box warning for serious infection

Question 3

Humira

Answer 3

TNF Inhibitor. Human Monoclonal Antibody. Binds to TNF-a and blocks its interaction with TNF receptors.

Generic Name: Adalimumab
Dosing: initial dose: 80mg injection, followed by 40mg every other week.
Adverse Events: headache, injection site reaction, upper respiratory infection
Efficacy: PASI75 at week 16 71%
Black Box Warning for malignancies

Question 4

Stelara

Answer 4

IL-12/23 Inhibitor

Generic Name: Ustekinumab
Dosing: injection 45mg initially and 4 weeks later, followed by every 12weeks. Higher weight patient is 90mg
Adverse Events: fatigue, headache, upper respiratory infection
Efficacy: PASI75 week 12 67.1%
*tend to loose efficacy week 8,9,10 typically in overweight patients

Question 5

Cosentyx

Answer 5

IL-17a Inhibitor

Generic Name: Secukinumab
Dosing: 300mg (2 injections of 150mg) injection weeks 0,1,2,3,4 then every 4 weeks.
Adverse Events: cold symptoms, diarrhea, upper respiratory infection
Efficacy: PASI75 week 12 81.6%

Question 6

Taltz

Answer 6

IL-17a Inhibitor

Generic Name: Ixekizumab
Dosing: 160mg (2 80mg) injections) week 0,2,4,6,8,12, then every 4 weeks
Adverse Events: injection sit reaction, upper respiratory tract infection
Efficacy: PASI75 week 12 89%

Question 7

Siliq

Answer 7

IL-17a Inhibitor

Generic Name: Brodalumab
Dosing: 210mg injection weeks 0,1,2 then every 2 weeks
Adverse Events: joint pain, headache
Efficacy: PASI75 week 12 83.3%

*has black box warning suicidal ideation for their warning you also have to be registered to prescribe it because of that.
A Risk Evaluation and Mitigation Strategy (REMS) is a strategy to manage known or potential serious risks associated with a drug product, and is required by the FDA to ensure the benefits of a drug outweigh its risks

Question 8

Tremfya

Answer 8

IL-23 Inhibitor

Generic Name: Guselkumab
Dosing: 100mg injection week 0,4 and every 8 weeks
Adverse Events: upper respiratory infection, headache, injection site reaction
Efficacy: PASI90 at week 16 79%

Question 9

What is a biosimilar drug?

Answer 9

biological products that are are highly similar to an already fda approved product, that have been shown to have no clinical meaningful differences from the oringal product. None are currently approved in US

Question 10

What are the 4 most important factors when choosing treatment?

Answer 10

efficacy, safety, administration, access (insurance coverage)

Question 11

What is the first class of biologics approved for plaque psoriasis?

Answer 11

TNF-a inhibitors

Question 12

As of 2016 which drugs hold the market share?

Answer 12

TNF-a inhibitors

Question 13

What is the response target for treatment in clinical practice?

Answer 13

<1% BSA (body surface area) after 3mos

Question 14

TNF-a inhibitors carry a black box warning for what 2 risks?

Answer 14

infections and malignancy (cancerous tumors)

Question 15

What does TNF stand for?

Answer 15

Tumor Necrosis Factor Inhibitors

Question 16

Skyrizi

Answer 16

IL 23 inhibitor
*this is our biggest competitor

Generic Name: risankizumab-rzaa
Dosing: 150mg injection weeks 0,4,every 12 weeks after
Adverse Events: upper respiratory infection, headache, fatigue, injection sir reaction, tine infections (fungus)
Efficacy: PASI75 89%

Question 17

Enbrel adverse event percentage?

Answer 17

TNF Inhibitor

Upper respiratory- 27% and 28% placebo
Injection site reaction- 15% and 6% placebo

Question 18

Humira adverse event percentage?

Answer 18

TNF Inhibitor

Upper respiratory- 17% and 13% placebo
Injection site reaction- 8% and 1% placebo
Rash- 12% and 6% placebo
Headaches- 12% and 8% placebo

Question 19

Cimzia adverse event percentage?

Answer 19

Upper respiratory- 21.9% and 21% placebo
Injection site reaction- 3.2% and .6% placebo
Cough- 3.2% and 1.9% placebo
Headache- 3.8%

Question 20

Cosentyx adverse event percentage?

Answer 20

IL17

Upper respiratory- 28.7% and 18.9% placebo
Diarrhea- 4.1% and 1.4% placebo
Oral herpes- 1.3% and .3% placebo

Question 21

Taltz adverse event percentage?

Answer 21

IL17

Upper respiratory- 14% and 13% placebo
Injection site reaction- 17% and 3% placebo
Nausea- 2% and 1% placebo
Fungal infections- 2% and 1% placebo

Question 22

Siliq adverse event percentage?

Answer 22

IL17

Joint pain- 4.7% and 3.3% placebo
Headache- 4.3% and 3.5% placebo
Fatigue- 2.6% and 1.1% placebo
Diarrhea- 2.2% ad 1.1% placebo
Throat Pain- 2.1% and 1.1% placebo

Question 23

Tremfya adverse event percentage?

Answer 23

IL23

Upper respiratory- 14.3% and 12.8% placebo
Injection site reaction- 4.5% and 2.8% placebo
Headache- 4.6% and 3.3% placebo
Joint Pain- 2.7% and 2.1% placebo

Question 24

Skyrizi adverse event percentage?

Answer 24

IL23

Upper respiratory- 13% and 9.7% placebo
Headache- 3.5% and 2% placebo
Fatigue- 2.5% and 1 % placebo

Question 25

5 biggest competitors?

Answer 25

skyrizi, cosentyx, taltz, stelara, tremfya

Question 26

Stelara adverse events percentage?

Answer 26

IL 12/23 Upper respiratory- 13% and 13% placebo Headache- 5% and 3% placebo Fatigue 3% and 2% placebo

Question 27

Otezla adverse events percentage?

Answer 27

PDE 4 Inhibitor Upper respiratory- 9% and 6% placebo Diarrhea- 17% and 6% placebo Nausea- 17% and 7% placebo Headache- 6% and 4% placebo