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TREATMENT COMPARISON<br />
TRADITIONAL SYSTEMIC AND NEW ORAL TREATMENTS (SEE REVERSE FOR BIOLOGIC TREATMENTS)<br />
<strong>Treatment</strong> type - For moderate<br />
to severe psoriasis and psoriatic<br />
arthritis<br />
Otezla Methotrexate Cyclosporine Soriatane<br />
Apremilast<br />
Indication - Which diseases <strong>the</strong><br />
drug treats<br />
Psoriatic arthritis<br />
Psoriasis<br />
Psoriatic arthritis<br />
Psoriasis Psoriasis<br />
Method of delivery - How <strong>the</strong> drug<br />
is given or taken<br />
Orally via tablet<br />
Orally via liquid or pill or by<br />
subcutaneous injection<br />
Orally via liquid or capsule Orally via capsule<br />
Frequency - How often <strong>the</strong> drug<br />
must be taken<br />
30 mg twice daily Once per week; doses may be<br />
divided and taken three times<br />
over 24 hours<br />
Daily Daily<br />
Duration - How long <strong>the</strong> drug<br />
must be taken<br />
Continuously to maintain results Continuously to maintain results Up to one year maximum Continuously to maintain results<br />
Common side effects - A side<br />
effect is an undesirable secondary<br />
effect of a medication. Side effects<br />
may vary for each individual<br />
depending on disease state, age,<br />
weight, gender, ethnicity and<br />
general health. All medications<br />
have side effects.<br />
• Nausea<br />
• Diarrhea<br />
• Headache<br />
• Nausea<br />
• Tiredness<br />
• Difficulty sleeping<br />
• Light headedness<br />
• Mouth ulcers<br />
• Vomiting<br />
• Headache<br />
• Easy bruising<br />
• Fever<br />
• Chills<br />
• Decreased kidney function<br />
• Headache<br />
• High blood pressure<br />
• High cholesterol<br />
• Skin sensitivity<br />
• Flu-like symptoms<br />
• Upset stomach<br />
• Tiredness<br />
• Musculoskeletal pain<br />
• Hair loss<br />
• Chapped lips<br />
• Dry skin<br />
• Bleeding gums<br />
• Peeling fingertips<br />
• Changes in blood-fat levels<br />
• Depression<br />
• Headache<br />
• Joint pain<br />
Possible risks - The possible<br />
risks listed include serious<br />
adverse events that have been<br />
reported in association with <strong>the</strong>se<br />
medications during and after<br />
clinical trials.<br />
• Unexplained weight loss • Liver damage<br />
• Birth defects<br />
• Reduced white blood cell count<br />
• Increased toxicity in patients<br />
with poor kidney function<br />
• Kidney damage<br />
• Skin malignancies<br />
• Hypertension<br />
• Excessive hair growth<br />
• Tremor<br />
• Birth defects<br />
• Elevated cholesterol<br />
• Liver damage<br />
Monitoring - Some adverse<br />
reactions can be detected by<br />
laboratory tests such as blood<br />
counts or liver function tests.<br />
None Complete blood count<br />
Chem screen (liver, kidney<br />
function)<br />
Occasional liver biopsies<br />
Blood pressure monitoring<br />
Kidney function monitoring<br />
Liver enzyme testing<br />
Cholesterol screening<br />
Triglyceride monitoring<br />
<strong>National</strong> Psoriasis Foundation educational materials are medically reviewed and are not intended to replace <strong>the</strong> counsel of a physician. The Psoriasis Foundation does not endorse any<br />
medications, products or treatments for psoriasis or psoriatic arthritis and advises you to consult a physician before initiating any treatment.
BIOLOGIC TREATMENTS (SEE REVERSE FOR NEW ORAL AND TRADITIONAL SYSTEMIC TREATMENTS)<br />
<strong>Treatment</strong> type - For moderate<br />
to severe psoriasis and psoriatic<br />
arthritis<br />
Indication - Which diseases <strong>the</strong><br />
drug treats<br />
Cimzia<br />
Certolizumab pegol<br />
Psoriatic arthritis<br />
Enbrel<br />
Etanercept<br />
Psoriasis<br />
Psoriatic arthritis<br />
Humira<br />
Adalimumab<br />
Psoriasis<br />
Psoriatic arthritis<br />
Remicade<br />
Infliximab<br />
Psoriasis<br />
Psoriatic arthritis<br />
Simponi<br />
Golimumab<br />
Psoriatic arthritis<br />
Stelara<br />
Ustekinumab<br />
Psoriasis<br />
Psoriatic arthritis<br />
Method of delivery - How <strong>the</strong> drug<br />
is given or taken<br />
Subcutaneous injection by a<br />
health care professional, or<br />
self-injection<br />
Subcutaneous selfinjection<br />
Subcutaneous selfinjection<br />
Intravenous infusion by<br />
health care professional<br />
Subcutaneous selfinjection<br />
Subcutaneous injection by<br />
a health care professional<br />
Frequency - How often <strong>the</strong> drug<br />
must be taken<br />
Week 0, week 2, and week 4,<br />
and ei<strong>the</strong>r every two weeks<br />
or every four weeks<br />
<strong>the</strong>reafter<br />
1-2 times weekly Every o<strong>the</strong>r week 3 times in first 6 weeks,<br />
<strong>the</strong>n every 8 weeks<br />
Monthly Week 0, week 4, <strong>the</strong>n<br />
every 3 months<br />
Duration - How long <strong>the</strong> drug<br />
must be taken<br />
Continuously to maintain<br />
results<br />
Continuously to maintain<br />
results<br />
Continuously to maintain<br />
results<br />
Continuously to maintain<br />
results<br />
Continuously to maintain<br />
results<br />
Continuously to maintain<br />
results<br />
Common side effects - A side<br />
effect is an undesirable secondary<br />
effect of a medication. Side effects<br />
may vary for each individual<br />
depending on disease state, age,<br />
weight, gender, ethnicity and<br />
general health. All medications<br />
have side effects.<br />
• Upper respiratory<br />
infection<br />
• Rash<br />
• Urinary tract infections<br />
• Headache<br />
• Fatigue<br />
• Nausea<br />
• Injection site reactions<br />
• Upper respiratory<br />
infections<br />
• Headaches<br />
• Injection site reactions<br />
• Upper respiratory<br />
infections<br />
• Headaches<br />
• Rash<br />
• Nausea<br />
• Respiratory infections<br />
• Headache<br />
• Rash<br />
• Coughing<br />
• Stomach pain<br />
• Upper respiratory<br />
infection<br />
• Nausea<br />
• Abnormal liver tests<br />
• Injection site reactions<br />
• High blood pressure<br />
• Bronchitis<br />
• Dizziness<br />
• Flu<br />
• Upper respiratory<br />
infections<br />
• Headache<br />
• Tiredness<br />
• Fatigue<br />
Possible risks - The possible<br />
risks listed include serious<br />
adverse events that have been<br />
reported in association with <strong>the</strong>se<br />
medications during and after<br />
clinical trials.<br />
• Serious infection<br />
• Nervous system<br />
problems<br />
• New or worsening heart<br />
failure<br />
• Allergic reactions<br />
• Lupus-like syndrome<br />
• Malignancies<br />
• Hepatitis B reactivation<br />
• Serious infection<br />
• Nervous system<br />
problems<br />
• New or worsening heart<br />
failure<br />
• Allergic reactions<br />
• Lupus-like syndrome<br />
• Lymphoma<br />
• Hepatitis B reactivation<br />
• Skin cancer<br />
• Serious infection<br />
• Nervous system<br />
problems<br />
• New or worsening heart<br />
failure<br />
• Allergic reactions<br />
• Lupus-like syndrome<br />
• Lymphoma<br />
• Hepatitis B reactivation<br />
• Skin cancer<br />
• Serious infection<br />
• Nervous system<br />
problems<br />
• New or worsening heart<br />
failure<br />
• Allergic reactions<br />
• Lupus-like syndrome<br />
• Lymphoma<br />
• Hepatitis B reactivation<br />
• Skin cancer<br />
• Anaphylaxis<br />
• Liver enzyme<br />
abnormalities<br />
• Hepatitis B reactivation<br />
• New or worsening heart<br />
failure<br />
• Nervous system<br />
problems<br />
• Liver failure<br />
• Low blood count<br />
• Lupus-like symptoms<br />
• Allergic reactions<br />
• Lymphoma<br />
• Increased risk of<br />
serious infections<br />
• Reactivation of latent<br />
infections, including<br />
tuberculosis<br />
• Reversible posterior<br />
leukoencephalopathy<br />
syndrome<br />
• Hypersensitivity<br />
reactions<br />
Monitoring - Some adverse<br />
reactions can be detected by<br />
laboratory tests such as blood<br />
counts or liver function tests.<br />
Tuberculosis screening<br />
Annual blood count and<br />
liver function tests<br />
Tuberculosis screening<br />
Annual blood count and<br />
liver function tests<br />
Tuberculosis screening<br />
Annual blood count and<br />
liver function tests<br />
Tuberculosis screening<br />
Annual blood count and<br />
liver function tests<br />
Tuberculosis screening<br />
Annual blood count and<br />
liver function tests<br />
Tuberculosis screening<br />
<strong>National</strong> Psoriasis Foundation educational materials are medically reviewed and are not intended to replace <strong>the</strong> counsel of a physician. The Psoriasis Foundation does not endorse any medications,<br />
products or treatments for psoriasis or psoriatic arthritis and advises you to consult a physician before initiating any treatment.
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