Simponi Vs Humira (Golimumab vs Adalimumab) is a comparison of the two novel TNF inhibitors. Both of these drugs are TNF (Tumor Necrosis Factor) Inhibitors. Their function is to reduce inflammation in different disease conditions. These two drugs will be compared based on the mechanism of action, dosage formulations, pharmacokinetics, and efficacy in different conditions.
Indications of Simponi vs Humira (Golimumab Vs Adalimumab):
Different conditions in which these drugs are indicated include:
Simponi (Golimumab) | Humira (Adalimumab) |
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Simponi (Golimumab) VS Humira (Adalimumab) Pharmacokinetics:
Mechanism | Simponi (Golimumab) | Humira (Adalimumab) |
| Bioavailability | 53% | 64% |
| Half-life | 2 weeks | 10-20 days |
| Absorption | Achieves a maximum concentration after 2-6 days of subcutaneous administration | A maximum serum concentration of 4.7± 1.6 μg/mL was achieved in 131 ± 56 hours. |
| Clearance | 4.9-6.7 ml/day/kg after 1 dose | 12 mL/hour |
Mechanism of action of Simponi vs Humira (Golimumab Vs Adalimumab):
Simponi | Humira |
| Golimumab (Simponi) is a human monoclonal antibody, it binds to soluble and transmembrane TNF-α and inhibits its secretion. As a result, it prevents the binding of TNF-α to its receptors which ultimately stops leukocyte infiltration by inhibiting E-selectins, ICAM-1 and VCAM-1. It also inhibits Interleukin-6 and Interleukin-8 that are pro-inflammatory cytokines. This decreases or prevents inflammation in chronic inflammatory conditions. | Adalimumab binds to TNF-α this binding blocks its interaction with cell surface receptors. TNF is a naturally occurring cytokine that plays role in inflammation, its levels are increased in certain disease conditions. Adalimumab helps in reducing pathologic inflammation. It does not affect TNF-β.
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Simponi vs Humira in pregnancy and lactation:
Humira (Adalimumab):
- Humira is ranked in pregnancy B category drugs. The treatment with this medication can be continued if the benefits outweigh the risks. In various clinical trials, there is no association of administration of Humira with miscarriage, infertility, or increased risk of birth defects. But as adalimumab is an immune suppressant it must be used with caution during pregnancy
- During breastfeeding, adalimumab can be continued because only low levels are present in breast milk. Infants can receive non-infectious vaccines but live vaccination should be avoided if there is any chance of the presence of adalimumab in the infant’s body.
Simponi (Golimumab):
- Golimumab is also ranked under category B. No adverse events have been reported but the number of trials conducted on the use of golimumab during pregnancy is low. A greater risk is associated with exposure to golimumab in utero.
- The secretion of golimumab in breast milk is unknown. In one clinical trial a woman undergoing golimumab therapy breastfed an infant, the study concluded that there was no difference in growth or development of the infant from any other normal infant.
Simponi and Humira are Pregnancy Risk Category B Drugs
Simponi vs Humira efficacy in different conditions:
Adalimumab Vs Golimumab in Rheumatoid arthritis:
- Humira (Adalimumab) is the first human antibody against TNF-α for the treatment of rheumatoid arthritis. Based on clinical trials, it is an effective treatment against rheumatoid arthritis. Adalimumab efficiently reduces joint pain and decreases the risk of physical disability. Its recommended dosage for rheumatoid arthritis treatment is 40 mg every week. It shows greater effectiveness when used along with methotrexate. It is generally well-tolerated and the only common adverse event is injection site reaction. Some serious infections such as tuberculosis have been reported in the long-term use of adalimumab [Ref]
- Simponi (Golimumab) is the latest anti-TNF-α drug approved by FDA. It is approved for the treatment of rheumatoid arthritis. 50 mg injection once in four weeks is the recommended dosage for RA. Golimumab is a better choice for rheumatoid arthritis treatment due to low levels of immunogenicity, low risk of adverse reactions on discontinuation, and lesser injection site reactions as compared to other TNF inhibitors including adalimumab (Humira). There is no head- to head comparison of golimumab with any other TNF inhibitor, but the indirect comparison suggests that golimumab is possibly better tolerated than any other TNF inhibitor [Ref].
Simponi (golimumab) is better tolerated than most TNF inhibitors
Simponi Vs Humira in Ankylosing spondylitis:
- Humira (Adalimumab) is known to significantly improve the signs and symptoms of patients with AS. In various clinical trials, adalimumab greatly improved all measures of disease activity including inflammation, back pain, improvements in spinal mobility, and reduction in enthesis pain. In some studies, adalimumab treatment was also found to benefit patients with total spinal ankylosis but further studies are still required in this regard. The efficacy of adalimumab in treating ankylosing spondylitis is similar to Etanercept and infliximab [Ref].
- In patients with ankylosis spondylitis, golimumab therapy is effective in reducing signs and symptoms. 50 and 100 injections are administered every 4 weeks for the treatment of AS. Golimumab therapy is associated with reduced back pain and inflammation along 50% is administered once every 4 weeks. This is a more convenient dosing schedule as compared to adalimumab. Golimumab patients have a significant reduction in sleep disturbance and overall fatigue symptoms associated with the treatment of ankylosing spondylitis [Ref].
Simponi has a more convenient dosing schedule
Humira Vs Simponi (Adalimumab Vs Golimumab) in Psoriatic arthritis:
- Adalimumab improves joint and skin manifestations reduce pain and disability and improves the quality of life in patients with psoriatic arthritis. Although effectiveness in axial psoriasis is not known. It can also help in the treatment of uveitis that occurs frequently in patients with psoriatic arthritis. Adalimumab is more effective in treating PsA with cyclosporine. Overall, it has a favorable risk-to-benefit ratio [Ref].
- Golimumab is effective in both peripheral as well as axial forms of psoriatic arthritis. It is approved for intravenous administration in PsA patients [Ref].
Simponi Vs Humira in Ulcerative colitis:
- Golimumab is safe and effective in the treatment of ulcerative colitis. But there is still less evidence for its optimal use. Further evidence is required to know the benefits of using golimumab along with an immunomodulator [Ref].
- Adalimumab is rather more effective for the maintenance of steroid-free remission in ulcerative colitis. Adalimumab treatment lowers the colectomy rate and is known to achieve mucosal healing. It is also convenient for patients due to the self-injection facility. Another potential advantage of adalimumab is the effectiveness of monotherapy rather than in combination with any other drug. This may be appealing as combination therapy is associated with an increased risk of side effects [Ref].
Simponi vs Humira in COVID-19 Infection:
TNF inhibitors are effective for the management of patients with covid-19. Various studies show that immune response management can reduce the severity of symptoms in COVID-19. This is because TNF-α is a cytokine that is involved in acute phase response. This cytokine is associated with impaired lung function.
In this way, TNF inhibitors help to decrease disease severity in COVID-19 patients. A study showed that patients who were already on TNF-α inhibitors developed less severe forms of infections during COVID-19. According to current studies both Simponi and Humira can play a beneficial role in COVID-19 but still, further evidence is needed in this regard.
Conclusion:
Although both drugs can be used in each of the above-mentioned conditions, Simponi (Golimumab) is considered better than Humira (Adalimumab) in treating rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. While Adalimumab is a better treatment option for ulcerative colitis.