COMPARATIVE TABLE

Drag the logos of the molecules that you wish to compare (at the bottom of the table) into the columns.

LogoTrade name / Generic nameProgram / CompanyMode of actionIndications (year discovered)Dosage, means of administrationInjector/Syringe/VialEliminationEffectiveness**Side effectsContraindications (CI), precautionsPre-treatment testsCostsStabilityRefillN.BN.BN.BSheets / Forms / Print

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Cosentyx / SecukinumabXpose / NovartisHuman IgG1κ antibody that binds selectively to IL-17A and neutralizes it
  • Plaque psoriasis (2015)
  • Ankylosing spondylarthritis (2016)
  • Psoriatic arthritis (2016)
Psoriasis: 300 mg s/c (two 150-mg doses) (pre-filled syringe, SensoReady pen) Weeks 0, 1, 2, 3, 4 and then 1x/month (by date)
  • Half-life: 31 days
  • Total : 155 days
  • Week 3 : visible improvement at 50%
  • Week 12, PASI 75 : ~80%
  • Week 16, PASI 90 : ~70%
  • IVRS, reaction at the injection site (<1%)
  • Candidiasis
  • Precaution: active cancer. Take care if the patient has Crohn’s disease, ulcerative colitis, septicemia or tuberculosis
  • CI: Hypersensitivity to the product or its components
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
  • $1,545 for 300 mg
  • ~$24,000 the first year, then $18,540/year
  • Store in the refrigerator at 2 to 8°C
  • Keep out of the light.
  • Do not shake.
With RAMQ: First refill in the 4th month (schedule appointment before), then every 12 months.Do not administer live vaccines.No CI with SEP.Link for sheet, forms and to print
Dupixent / DupilumabFreedom / Sanofi GenzymeAnti-IL-4Rα;  prevents IL-4 and IL-13 signaling; Fully humanized recombinant monoclonal IgG4 antibodyModerate to severe atopic dermatitis in adults (2017) and in adolescents from 12 to 17 years old (2019)600 mg s/c (two 300-mg injections) s/c initially in week 0; then 300 mg s/c every 2 weeksTime to lowest detectable concentration: 10 weeksAt week 16: 38% of patients were «cleared» or «almost cleared»
  • Injection site reactions
  • Conjunctivitis and keratitis
  • Hypersensitivity to dupilumab
  • Precaution: It is unknown if dupixent will influence the immune response against helminth infections
NonePre-filled syringes (300 mg): $1,153.85Store in the refrigerator at 2°C to 8°C in the original carton to protect from light. If necessary, pre-filled syringes may be kept at room temperature up to 25°C (max of 14 days. Do not store above 25°C. ) After removal from the refrigerator, must be used within 14 days or discarded.First refill in the 4th month (schedule appointment before), then every 12 months.Link for sheet, forms and to print
Enbrel / ÉtanerceptEnliven / AmgenSoluble anti-TNF, binds to soluble TNF, preventing it from interacting with the receptors at the surface of the cell. Inhibits the TNF’s action without causing cell lysis
  • Rheumatoid arthritis (2000)
  • Juvenile idiopathic arthritis (2003)
  • Psoriatic arthritis (2003)
  • Ankylosing spondylarthritis (2004)
  • Psoriasis (2005)
  • Psoriasis (4-17 years) (2017)
  • Psoriasis: 50 mg s/c 2x/week x 3 months, then 1-2x/week.
  • Pso (4-17 years): 0,8 mg/kg s/c each week (max 50 mg)
  • Other indications: 50 mg/week
  • Half-life: 4.3 days
  • Total : 5 ½ lives
  • Week 12, PASI 75 : 55% - 60%
  • Week 24, PASI 75 : 59%
Suppresses the immune system, leading to 6% non-neutralizing antibodies (no loss of effectiveness, 100% of the medication remains metabolized)Multiple sclerosis, cancer, hepatitis B, moderate or severe heart failure (class III and IV)
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
  • $18,395 (first year at 50 mg/week starting on the 12th week)
  • $29,892/year if taking 50 mg 2x/week
Stable for 60 days outside the fridge at 27°CFirst refill in the 4th month (schedule appointment before), then every 12 months.Link for sheet, forms and to print
Humira / AdalimumabAbbVie Care / AbbVieAnti-TNF, recombinant human IgG2 monoclonal antibody
  • Rheumatoid polyarthritis (2004)
  • Psoriatic arthritis (2006)
  • Ankylosing spondylarthritis (2006)
  • Crohn’s disease in adults (2007)
  • Plaque psoriasis (2008)
  • Polyarticular juvenile idiopathic arthritis (2012)
  • Crohn’s disease in adults in children (2013)
  • Ulcerative colitis (2013)
  • Hidradenitis suppurativa (2015) also among adolescents (2019) aged 12 to 17 (30 kg or more)
  • Non-infectious uveitis (2016)
  • Psoriasis: 80 mg s/c on day 0, 40 mg in week 1 and then every 2 weeks
  • HS: 160 mg s/c on day 0, 80 mg in week 2, 40 mg in week 4, then every week
  • HS in adolescents: 80 mg s/c day 0, 40 mg week 1 and q 2 weeks thereafter. It can be increased to 40 mg s/c q 1 week if not effective
  • Auto-injector or pre-filled syringe
  • Latex-free
Half-life: Approximately 2 weeks (10-20 days)
  • Week 4 : visible improvement
  • Week 16,
  • PASI 75 : 71% - 80%
  • PASI 90 : 45% - 52%
  • Suppresses the immune system
  • Reaction at the injection site
  • CI: Known hypersensitivity to Humira, active infection, moderate or severe heart failure (class III and IV), multiple sclerosis
  • Precautions: Hepatosplenic T-cell lymphoma, infections, active cancer
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
  • Pso: $19,999 the first year, then $18,570/year
  • HS: $38,570 the first year, then $37,140/year
  • Store in the refrigerator at 2 to 8°C
  • Keep the pre-filled pen or syringe at maximum 25°C (77°F) for a single period not exceeding 14 days
  • Keep out of direct sunlight. Do not freeze.
First refill in the 4th month (schedule appointment before), then every 12 months.Immunogenicity: Possible loss of effectiveness if treatment spaced out or resumed after temporarily stopping.Link for sheet, forms and to print
Otezla / ApremilastInnomar (EZ-Start) / CelgeneIntracellular PDE4 inhibitor. Modulates a network of pro-inflammatory and anti-inflammatory mediators
  • Plaque psoriasis (2014)
  • Psoriatic arthritis (2015)
  • Administered via bone, gradually increase according to the starter packet (not available in pharmacies, expect 7-10 weeks for delivery), then 30 mg BID via bone
  • Lower dose to 30 mg ID (if ClCr <30)
  • Two starter packets as needed. The medication can be divided in two (homogeneous)
  • Maximum half-life: 9 hours
  • Total : 2 days
  • Increased efficiency (palmoplantar, nails and scalp)
  • Start of improvement: skin: 4 weeks, itchiness: 2 weeks, joint pain: 8 weeks
  • Maximum effectiveness after 32 weeks
  • Weight loss (5% of BMI) in 20% of patients (up to 1 year)
  • Frequent: diarrhea, nausea, headaches
  • Depression
Generally resorbed after 4 weeks of treatment
  • Precautions: Kidney failure. Oztela contains lactose (see the monograph). Drug interactions (see N.B).
  • CI: hypersensitivity to the product and its components, pregnancy, breastfeeding
  • Creatinine
  • Weight gain
$13,200 for the first year, then $13,800 per yearKeep between 15 and 30°CFirst refill in the 4th month (schedule appointment before), then every 12 months.No immunogenicity, therefore no loss of effectiveness if person stops and restarts treatment.Tegretol, dilantin, phenobarbital, rifampicin, St. John’s wort (CYP3A4 indicators) reduce Otezla’s effectivenessLink for sheet, forms and to print
Remicade / InfliximabBioadvance / JanssenAnti-TNF, binds to and neutralizes TNF-alpha
  • Plaque psoriasis (1998)
  • Rheumatoid polyarthritis
  • Ankylosing spondylarthritis
  • Crohn’s disease in adults and children
  • Psoriatic arthritis
  • Ulcerative colitis in adults and children
  • 3 to 5 mg/kg
  • IV in weeks 0, 2 and 6 and q 8 weeks
  • (2 h + 1 h monitoring p-e +)
  • Half-life 7.7 to 10 days
  • Total : 5 ½ lives
  • Week 10,
  • PASI 75 : 72% - 80%
  • PASI 90 : 46% - 57%
Suppresses the immune systemMultiple sclerosis, cancer, hepatitis B, moderate or severe heart failure (class III and IV), active infection
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
$940/vial (100 mg)Initial request approved for max. 4 months, then every 12 months (according to case, list [do not substitute] given biosimilar)Patient must go to the perfusion centre. Televisions and Wi-Fi available.Link for sheet, forms and to print
Siliq/BrodalumabSILIQ ACTIVATION/Bausch HealthAntibody IgG2 binds to IL-17RA (receptor)Psoriasis (2008)210 mg s/c weeks 0, 1, 2 then q 2 weeksHalf-life: 10,9 days
  • Week 12: PASI 75 : ≈85% | PASI 90 : ≈70%
  • Week 52: PASI 100 : ≈51%
  • Supresses the immune system
  • Reaction at the injection site
  • Candidiasis
  • CI: Crohn’s disease
  • Precautions: Suicidal thoughts and behaviours (no causal relationship has been established)
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
  • $645 per injection
  • First year = $18060
  • Subsequent years = $16770
Store in the refrigerator at 2 to 8°C. Keep out of the light. Can be stored between 9 to 25°C for a maximum of 14 days.First refill in the 4th month (schedule appointment before), then every 12 months.Do not administer live vaccines.Link for sheet, forms and to print
Stelara / UstekinumabBioadvance / JanssenAnti-IL-12 and IL-23 antibody, binds to p40 (common to IL-12 and IL-23) and blocks Th1 and Th17 cells
  • Psoriasis (2008)
  • Psoriasis in adolescents (12-17 years) (2016)
  • Psoriatic arthritis (2014)
  • Crohn’s disease (2016)
  • 45-90 mg (if 100+ kg) s/c weeks 0 and 4, then q 12 weeks (sometimes 8)
  • For ages 12-17 (by body weight): <60 kg: 0.75 mg/kg | 60 to 100 kg: 45 mg | >100 kg: 90 mg
NO auto-injector pen. Pre-filled syringes with retractable needle
  • Half-life: 15-32 days
  • Total : 5 ½ lives
  • Week 12 : visible improvement
  • Weeks 20-24,
  • PASI 75 : 74% (71% for 100-kg pts receiving 90 mg)
  • PASI 90 : ~50%
  • Supresses the immune system
  • Reaction at the injection site
Active cancer, active infection, tuberculosis
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
  • $4,311.72 per injection (same price for 45 mg and 90 mg)
  • $25,870 for the first year, then $21,558 per year
Store in the refrigerator at 2 to 8°C. Keep out of the light.First refill in 5th month, schedule appointment before, then every 12 months.Can be used if SEPNo immunogenicity, therefore no loss of effectiveness even if the patient stops and restarts treatment.Do not administer live vaccines.Link for sheet, forms and to print
Taltz / IxekizumabLilly Plus / Eli Lilly CanadaIgG4 monoclonal antibody that binds strongly to IL-17A and neutralizes it
  • Moderate to severe plaque psoriasis (2016)
  • Psoriatic arthritis (2018)
  • 160 mg s/c (two 80-mg injections) initially in week 0), then:
  • 80 mg (1 inj.) in weeks 2, 4, 6, 8, 10 and 12, then:
  • 80 mg (1 inj.) once every 4 weeks
  • Auto-injector or pre-filled syringe (80 mg/1 ml)
Half-life: Approx. 13 days
  • Week 4, PASI 75 : ≈50%
  • Week 12, PASI 75 : ≈87% | PASI 90 : ≈70% | PASI 100 : ≈37%
  • Week 60, PASI 100 : ≈50%
  • Reaction at the injection site
  • Upper respiratory tract infections
  • Tinea pedis
  • Oral candidiasis
  • Active cancer, active infection, tuberculosis
  • Precaution: Crohn’s disease and ulcerative colitis
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
  • First year = $25,823
  • Subsequent years = $19,747
Store in the refrigerator at 2 to 8°C (36-46°F). Do not freeze. Keep out of the light. Do not shake.With RAMQ: First refill in the 4th month (schedule appointment before), then every 12 months.Do not administer live vaccines.No CI with SEPLink for sheet, forms and to print
Tremfya / GuselkumabBioadvance / JanssenAntibody anti-IL-23, binds to p19 (block Th17)Psoriasis (2017)
  • 100 mg s/c weeks 0 and 4, then q 8 weeks.
  • Pre-filled syringes with retractable needles or One-Press device
Half-life: 15-18 days
  • Weeks 4-8 : visible improvement
  • Week 16,
  • PASI 75 : 91%
  • PASI 90 : 73%
  • Supresses the immune system
  • Reaction at the injection site
Active cancer, active infection, tuberculosis
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
To be specifiedStore in the refrigerator at 2 to 8°C. Keep out of the light. Can be kept between 9 and 25°C for 4 hours max (1 period only).To be specifiedCan be used if SEP. No immunogenicity, therefore no loss of effectiveness even if the patient stops and restarts treatment.
  • Pso arthritis: ongoing phase 3 studies
  • MII : ongoing phase 2 studies
Do not administer live vaccines.Link for sheet, forms and to print
Skyrizi / RisankizumabAbbVie Care / AbbVieAntibody anti-IL-23, binds to p19 (block Th17)Psoriasis (2019)
  • 2 x 75mg s/c week 0, week 4, then q 12 week
  • NO auto-injector pencil, pre-filled syringes with needle protection device
Half-life: 28 days
  • Weeks 4-8 : visible improvement
  • PASI 75 : 87% (week 12)
  • PASI 90 : 75% (week 16)
  • Supresses the immune system
  • Reaction at the injection site
Active cancer, active infection, tuberculosis
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis A, B and C, HIV
  • CBC, ALT, creatinine
To be specifiedStore in the refrigerator at 2 to 8°C. Keep out of the light.With RAMQ: First refill in the 4th month (schedule appointment before), then every 12 months.Can be used if SEPDo not administer live vaccines.Link for sheet, forms and to print
Xolair / OmalizumabXpose / NovartisUnknown for urticaria; IgG, anti-IgE, stabilizes mast cells
  • Chronic idiopathic urticaria (2014)
  • Moderate to severe allergic asthma in adults and adolescents 12 and older (2004) and children from 6 to 11 (2017)
  • (off-label: PB, atopic dermatitis)
Chronic idiopathic urticaria (CIU): 150 mg to 300 mg s/c q 4 weeks
  • Half-life: 26 days
  • Total : 5 ½ lives
  • Possible improvement after first injection.
  • For “slow” responders, effective after 12 to 24 weeks
  • Warning: Allergic reaction in 0.08% of cases. Monitor for 2 hours after the first 3 shots (not indicated for urticaria)
  • Headache, fatigue, reaction at the site (less frequent for CIU than asthma)
Hypersensitivity to the productNone for CIU
  • PFS 75 mg ($274)
  • PFS 150 mg ($617)
  • Vial 150 mg (QC $618; Rest of Canada $624)
Store in the refrigerator at 2 to 8°C. As it does not contain any preservatives, it is recommended that XOLAIR be used immediately after its reconstitution (within 4 hours)."Exceptional medication". Criteria: CIU / UAS7 score of 16 or more despite the use of antihistamines at optimized doses. Accepted for a maximum of 24 weeks. Re-treatment: If complete response of short duration (UAS7≤6 for less than 12 weeks) or partial response (UAS7 >6, but decrease of 9.5 or more)CIU guidelines: Second-generation antihistamines ad 4x the dose for 1 to 4 weeksResponse is maintained during re-tx.Link for sheet, forms and to print
Cimzia / Certolizumab pegolCimzia Solutions / UCB CanadaAnti-TNF, conjugated to PEG molecule, devoid of Fc fragment
  • Psoriasis (2018)
  • Psoriatic arthritis (2014)
  • Ankylosing spondylitis (2014)
  • Rheumatoid arthritis (2009)
  • 400 mg s/c every 2 weeks OR
  • 400 mg s/c sem 0, 2, 4 then 200 mg s/c every 2 weeks
  • Auto-injector or pre-filled syringe (200 mg)
Half-life: 14 days
  • At 16 weeks, with 400mg every 2 weeks :
  • PASI 75 : ~75%
  • PASI 90 : ~45%
  • Supresses the immune system
  • Reaction at the injection site
Multiple sclerosis, cancer, hepatitis B, moderate or severe heart failure (class III and IV)
  • QuantiFERON (if PPD indeterminate, chest x-ray)
  • Serology: Hepatitis B and C, HIV
  • CBC, ALT, creatinine
To be specifiedStore in the refrigerator at 2 to 8°C . Do not freeze. Keep out of direct sunlight. Can be kept betwwen 9 and 25°C for a single period not exceeding 10 daysTo be specifiedDo not administer live vaccinesIf allergy to latex : needle protector contains latexSafe in pregnancy and lactationLink for sheet, forms and to print

*Note that the data provided must be interpreted with caution given the inherent variations between studies.

Special thanks to nurses Andréa Bossé and Marie-Eve Fortier for their help in creating this table.