Allergies are a prevalent cause of diseases that can strike anyone. Allergies can be caused by various factors, including pollen, diet, and medicine, making it difficult to determine the proper home remedies and best treatments.
Treatment of Allergic Reactions
Home remedies and over-the-counter drugs are valuable options to prevent and treat many allergic reactions that can range from mild to severe. Different treatment options are available and commonly used to alleviate allergic symptoms. Treatment options for allergies and immunology continue to expand, thanks mainly to a medicine family known as biologics. These drugs, which are derived from living organisms, can target specific components of the immune system and prevent inflammation, which can cause several illnesses.
Biologics are monoclonal antibodies or drugs administered as a shot or as an IV infusion. They are blood proteins generated by humans. They are created by experts utilizing cells from living species. Biologics bind to components of your immune system that cause asthmatic inflammation and suppress it. Biologics reduce the precise, focused immune response, allowing asthma to be controlled without needing a broader immunosuppressive drug like prednisone, which has numerous adverse effects.
The following are the biologics used for the treatment of allergies.
The first and only biologic medicine to be authorized by the FDA was Xolair in 2003 to treat moderate-to-severe persistent allergic asthma.
Xolair is a prescription medication used to treat Allergic Asthma and Chronic Idiopathic Urticaria symptoms (CIU). Xolair can be taken alone or in combination with other drugs.
Xolair belongs to the Monoclonal Antibodies, Anti-asthmatics family of medicines.
The effectiveness and safety of Xolair is unclear in children under six.
Suspension culture of Chinese hamster ovary cells in a nutritional medium with the antibiotic gentamicin leads to the production of Xolair. The presence of gentamicin in the finished product is undetectable. Xolair is given as a subcutaneous injection (SC) in a single-use vial of sterile, white, preservative-free lyophilized powder reconstituted with Sterile Water for Injection (SWFI) USP.
XOLAIR is mainly prescribed for adults and children aged 6 and up who have moderate to severe persistent asthma, also indicated in those individuals where symptoms are not managed well with inhaled corticosteroids. Moreover, in people who have a positive skin test or in vitro reactivity to a perennial aeroallergen.
Individuals with chronic idiopathic urticaria or adults and adolescents 12 years of age who remain symptomatic despite H1 antihistamine therapy should take Xolair.
Dupixent is a member of the class of drugs known as monoclonal antibodies. These medications target a particular area of the immune system.
The available forms of Dupixent in the market include prefilled single-dose syringes and pens. It is administered with a subcutaneous injection (under your skin). Dupixent is available in two doses: 200 mg/1.14 mL and 300 mg/2 mL solutions.
When topical treatments for atopic dermatitis are insufficient or inappropriate, Dupixent can be prescribed to patients aged 12 and up with mild to severe atopic dermatitis. If the patient’s condition is serious, the drug can also be administered to children aged 6 to 1. In individuals 6 years or older whose asthma is not well controlled by a combination of medications, Dupixent can be prescribed for maintenance treatment for severe asthma and when a combination of medicines does not control asthma well. Dupixent is exclusively prescribed for individuals who have a kind of airway inflammation known as ‘type 2 inflammation.’
Mepolizumab is a first-in-class monoclonal antibody that targets IL-5 that was authorized in 2015 for chronic eosinophilic asthma. It reduces blood eosinophils without eliminating them by inhibiting IL-5 from attaching to its receptor on the surface of eosinophils.
Mepolizumab is a drug designed and sold under the brand name Nucala in the US, Europe, and over 20 other markets as an add-on maintenance medication for patients with severe eosinophilic asthma to treat disorders associated with eosinophil inflammation. It has been examined in over 3,000 patients in 21 clinical trials spanning a variety of eosinophilic indications (SEA). In Europe and the United States, it is licensed to treat severe eosinophilic asthma in children aged six to seventeen.
It is mainly used for polyangiitis therapy for elderly patients with eosinophilic granulomatosis.
It can also be used for the treatment of hypereosinophilic syndrome (HES) in adults and children aged 12 and above for 6 months without an identified non-hematologic secondary cause.
In individuals 18 years and older, it is prescribed as maintenance therapy for chronic rhinosinusitis with nasal polyps (CRSwNP) for those who have not responded to nasal corticosteroids.
The FDA approved FASENRA in 2017. It is a biologic that may help individuals with severe eosinophilic asthma who have not shown improvement with existing prescription drugs. FASENRA is an asthma medication used to treat individuals with eosinophilic asthma. Eosinophils are white blood cells that help the immune system fight diseases and parasites.
FASENRA is the first and only respiratory biologic to incorporate Q8W maintenance dosing with at-home or in-office administration choices, resulting in the minimum injections per year for patients. The prefilled syringes and prefilled pens of FASENRA are available as a solution for injection. However, it must be sold on a prescription, and physicians with expertise in diagnosing and treating severe asthma should begin therapy.
The suggested dosage is 30 mg injected beneath the skin of the thighs or abdomen once every four weeks for the first three doses and once every eight weeks after that. The injection must be injected beneath the skin of the upper arm if delivered by a doctor or caregiver. It’s used to supplement a combination of high-dose inhaled corticosteroids and drugs known as long-acting beta-agonists in individuals with severe asthma who aren’t getting enough relief. The active ingredient in FASENRA is Benralizumab.
FASENRA should only be used under the supervision of a medical expert. In addition, patients should be monitored after receiving biological medicines, as advised by clinical practice. After getting suitable training in subcutaneous injection techniques and a healthcare practitioner certifying that it is acceptable, patients/caregivers may use the FASENRA Pen.
What is Fabry disease?
Fabry disease is a genetic disease that occurs due to a mutation in a gene. An individual who receives this gene is unable to make adequate alpha-galactosidase A, or alpha-GAL, a vital enzyme. Alpha-GAL removes a fatty molecule known as globotriaosylceramide, or GL-3, by breaking it down. There was insufficient production of active alpha-GAL in a patient with Fabry disease, which is why GL-3 accumulates in the cells rather than being eliminated. As GL-3 accumulates in the blood vessels and their walls and other tissues over time, it becomes more and more dangerous. The heart, kidneys, and brain are all major organ systems that may ultimately stop working correctly, posing a life-threatening hazard. In Fabry disease, the most significant symptoms generally appear in the fourth or fifth decade of life. On the other hand, signs and symptoms may arise considerably sooner. The treatment and management of the disease may start early if it is diagnosed early.
Occurrence of Fabry disease
Classic Fabry disease affects around 1 in every 40,000 men. Atypical Fabry disease, also known as Late-onset Fabry disease, is more prevalent. It affects around 1 out of every 1,500 to 4,000 men.
Researchers are still looking into how many women are affected by Fabry disease. The illness remains undetected commonly in women because some females have no symptoms or have minor, easy-to-ignore signs.
Types of Fabry disease
The different kinds of Fabry disease are determined by the age at which symptoms first show. The following are different types:
The symptoms of classic Fabry disease first occur in childhood or adolescence. One of the most common symptoms of the condition is a severe burning feeling in the hands and feet, which may start as early as age two. With the passage of time, the symptoms get more severe.
Symptoms of late-onset Fabry disease don’t appear until people are in their 30s or older. Renal failure or heart disease may be the earliest signs of a problem.
Causes of Fabry Disease
Fabry disease is inherited from one generation to the next.
The main issue is that your body is unable to produce alpha-galactosidase A, an enzyme required for the breakdown of fatty compounds such as oils, waxes, and fatty acids. The patients with Fabry disease either don’t have the enzyme or it isn’t working properly.
Symptoms of Fabry Disease
The following are the symptoms of Fabry disease:
Ringing in the ears
Bowel movements, stomach pain
Burning and pain in the hands
The appearance of small, dark red spots between knees and bellybutton
Management and Treatment of Fabry disease
Fabry disease has no known cure. Medications for pain and gastrointestinal issues may help to alleviate discomfort. There are two therapies that may help to avoid heart issues, renal illness, and other life-threatening effects by slowing the accumulation of fatty substances:
Enzyme replacement therapy:
An intravenous (IV) infusion of agalsidase beta enzyme (Fabrazyme®) prepared in the lab is given every two weeks to the patient. This replacement enzyme performs the functions of the lost alpha-GAL enzyme, preventing the accumulation of fatty compounds. To avoid an allergic reaction, you may be given an antihistamine and other drugs before starting treatment.
Fabrazyme (agalsidase beta) has been selected to treat over 5000 Fabry disease patients throughout the world, independent of the severity of the illness, enzyme activity, or kind of genetic mutation.
Oral chaperone therapy:
The repairing of the alpha-GAL enzyme can be done by Chaperones, which are tiny molecules that help in the repair process when it is damaged. The fatty material may subsequently be broken down by the repaired enzymes. Every other day, you take a tablet (migalastat [Galafold®]) to stabilise the malfunctioning alpha-GAL enzyme using this medication. This drug is not suitable for everyone with Fabry disease. If you are fit for this medication, it depends on your exact genetic mutation in the GLA gene.
With the help of stem cell technologies and genetic engineering, researchers are actively working to launch new treatments.
According to IQVIA, Americans paid $67 billion in out-of-pocket costs for prescriptions filled by retail pharmacies in 2019.
With COVID-19 adding another level of complexity to healthcare, employers are finding it even more challenging than pre-pandemic to cut costs while still providing quality health care benefits to their employees.
As a result, Pharmacy Benefit Managers (PBMs) are becoming more and more popular.
What are Pharmacy Benefit Managers (PBMs)?
PBMs have been around a lot longer than many realize. When insurance companies added prescription drugs to many health care benefits in the 1960s, the PBM role was created. Initially, PBMs would process claims for insurance claims. However, their role has evolved tremendously over the years.
The role of a Pharmacy Benefit Manager (PBM)
Today, PBMs are third-party administrators contracted by employers to provide prescription drug benefit management to their employees. They are also responsible for:
developing and managing pharmacy networks
negotiating discounts and rebates with drug manufacturers
developing and maintaining drug formularies
setting criteria for prior authorizations and the patient’s choice of pharmacy
In addition, a PBM provides resources and programs created to assist members in maintaining/improving their overall health. Working side by side with the member and their healthcare provider, a PBM can ensure the medications members take are safe and effective for their health conditions.
PBM companies in the United States
More than 80 PBM companies currently in the US offer consumers a wide range of drug plan options.
However, the healthcare system’s complexity combined with the urge to consolidate negotiating power has caused several PBMs, insurance companies, and pharmacies to merge.
Once your plan is finalized, your PBM can distribute benefits and familiarize employees with their health care coverage. Educational resources often include call centers, websites, and apps to easily access information about co-pays for different medications, pharmacies currently in-network, etc.
How PBMs work with insurance companies, pharmaceutical companies, and pharmacies
PBMs help insurance companies manage costs by negotiating with pharmaceutical manufacturers for discounts on medications. PBMs get the manufacturer’s drugs in front of millions of customers in exchange.
They also negotiate contracts with pharmacies to build networks of retail pharmacies for prescription drug distribution.
Offering cost-effective options such as pharmacy mail order fulfillment
Guiding plan participants to more generic and lower-cost brands
Insight & understanding
PBMs can provide the employers they are working with reports about medicine utilization. This information helps decrease drug waste while supporting medication compliance.
Up-to-date knowledge and expertise
Since PBMs are working directly with insurance and pharmaceutical companies, they can stay current with changes in prescription drugs. Employers then have the advantage of knowing industry changes in pricing, safety, and effectiveness.
The continual increase in prescription drug costs will emphasize managing the prescription drug benefit for employers.
It’s critical for companies to understand the role of their PBM, how they fit into their overall spending, and changes needed to their current health care plans to ensure that their members are constantly receiving the best possible care at the lowest possible cost.
Reclast (also marketed under the generic name zoledronic acid) is a bisphosphonate medication used to prevent or treat Osteoporosis or Paget’s Disease. However, unlike other bisphosphonates, Reclast bypasses the stomach because it’s given as an infusion, going right into the bloodstream.
If you or someone you know is suffering from either Paget’s Disease or Osteoporosis, Reclast may be able to help. We put this guide including essential information you should know regarding Reclast to help you decide if it could be the right treatment for you. Always consult with your physician before starting new medicines.
What are Osteoporosis and Paget’s Disease?
Our bones are living tissue that are regularly being broken down and regenerated. Osteoporosis occurs when new bone can’t keep up with the loss of old bone, causing bones to become weak and brittle. They can become so fragile that a cough or bending over could cause a fracture. These fractures often occur in the hip, wrist, or spine.
The human body has a recycling process in which new bone tissue slowly replaces old bone tissue. Paget’s Disease of bone interferes with this method, causing bones to become fragile and misshapen over time.
The most commonly affected areas are:
Complications and Symptoms
As there are typically no symptoms in the early stages, Osteoporosis can at first be silent. As Osteoporosis causes the bones to become weaker over time, symptoms may include:
Loss of height over time
A stooped posture
A bone that breaks/fractures easily
In particular, spine and hip fractures may cause chronic pain and disability or possibly, death.
Many people with Paget’s Disease are asymptomatic or develop mild symptoms. Others may experience one or more of the following symptoms:
joint pain (especially in the back, hips, and knees)
enlargement and bowing of the thighs (femurs) and lower legs (tibias)
enlarged skull in the forehead area
Risk Factors of Osteoporosis and Paget’s Disease
Knowing the risk factors for both of these conditions is important to help take steps to prevent or treat them before they become worse.
Osteoporosis Risk Factors
Major risk factors that you can’t control include:
White or Asian descent
Small bone structure
Parents with a history of a broken hip
Prior fracture, particularly after age 50
Other risks factors for Osteoporosis include:
Low levels of sex hormones, mainly estrogen in women
Insufficient calcium and vitamin D, either from low intake in your diet or inadequate absorption in your gut
Inactive lifestyle or immobility
Diagnosis of diseases that can affect bones, like Cushing’s Disease, Rheumatoid Arthritis, and Hyperthyroidism
Paget’s Disease of Bone Risk Factors
Factors that may increase your risk of Paget’s Disease include:
Over the age of 50
National origin- common in England, Scotland, central Europe, Greece, and countries settled by European immigrants.
Family history of the disease
What is Reclast, and How Does it Work?
Reclast belongs to the class of medications known as bisphosphonates, which prevent bone loss and reduce calcium released from the bones. It’s only available through a prescription and comes in the form of an injection.
This medication treats bone loss caused by menopause, steroid use, or low hormone levels. It may also be prescribed for those who have been on corticosteroid medications, like prednisone, for a long time.
Reclast binds to osteoclasts (bone cells), inhibiting the process of bone breakdown. As a result, Reclast decreases the rate of bone loss, promoting normal bone formation.
How Do You Use Reclast to Treat or Prevent Osteoporosis and Paget’s Disease?
Reclast is given as an infusion by a healthcare provider and only requires administration every year when treating Osteoporosis and every two years for preventing Osteoporosis.
The dosage amount depends on each patient’s medical condition, kidney function, and response to treatment.
For patients with high blood calcium levels, IV fluids are given before Reclast is injected. Many people are also instructed to drink plenty of fluids before treatment begins to prevent kidney issues. Your infusion provider should consult with you beforehand for prep instructions.
What are the Side Effects of Reclast?
Side effects may occur when using Reclast. Call your doctor if any of these symptoms don’t go away or get worse.
These side effects include:
Bone, muscle, and joint pain
*The flu-like symptoms generally disappear after 24-48 hours and usually occur only after the first injection
Serious side effects can also occur. If you experience any allergic reactions, hives, difficulty breathing, swelling of your face, lips, tongue, or throat, let your healthcare professional administering the injection know right away.
While cases are rare, some people have experienced low calcium levels in the blood (hypocalcemia), severe kidney issues, and severe bone, joint, and muscle pain. These symptoms are reported from 1 day to one month after starting any bisphosphonate, including Reclast.
Medication Interactions with Reclast
You should always disclose to your healthcare provider all other medications you are taking before starting Reclast, especially if you are taking:
If you or a loved one have ever had to start treatment for cancer, you are most likely already familiar with chemotherapy through infusion therapy. However, did you know infusion therapy also treats several other diseases and ailments?
From Myasthenia Gravis and Crohn’s disease to psoriatic arthritis and Alzheimer’s disease, infusion therapy is proving to be effective and efficient at managing many different medical conditions.
We put together this article to explain infusion therapy, its benefits, what ailments it can treat, and what to expect when getting infusion treatments.
What is infusion therapy?
Infusion therapy refers to different kinds of medication or fluids that are administered through a
needle or catheter, usually intravenously (IV). Healthcare professionals can also deliver it in other ways such as:
Certain drugs can’t be taken orally due to their decreased effectiveness when exposed to the digestive system. Infusion therapy is an alternative when there’s no other comparable oral therapy, or someone cannot take an oral form of the medication. It’s also a way of delivering medication that must be administered at a controlled pace.
Cancer treatment options, chemotherapy and immunotherapy, are often given by infusion.
While some chemotherapy medications can be taken by mouth, many are administered through an IV. Infusion therapy allows the delivery of chemotherapy drugs to pass directly into your bloodstream slowly to lessen side effects. The IV also enables you to receive other medications, like anti-nausea drugs, without the need for more needles.
Other cancer therapies, like immunotherapies, are made from monoclonal antibodies and given through an IV. Considered biologic drugs, monoclonal antibodies are laboratory-made proteins that act as substitute antibodies to repair, improve or copy the immune system’s attack on cells.
Redness, swelling, and pain at the infusion site are common. However, if you experience any of the following while getting your infusion, let the nurse/IV administrator know immediately:
Itching, rashes, or hives
Swelling of any part of your body, including lips, eyelids, or tongue
A flush of redness in your face and neck
Fever or chills
Shortness of breath
Pain in muscles or joints
You may also experience side effects specific to the medication you’re receiving by infusion. Consult with your healthcare provider about these possible side effects.
Infusion therapy has been used for a long time by hospitals worldwide. However, it’s readily becoming available in outpatient healthcare settings and patients’ homes by specialized nurses/healthcare professionals who are professionally trained to administer these IVs.
Biologics and biosimilar drugs might be two terms that you’re not familiar with regarding prescription medications. However, they are a lot more common than most people think.
Have you ever seen advertisements for Humira? Do you know about the flu and shingles vaccine? If you answered yes to either of those questions, you are well on your way to becoming familiar with biologics and biosimilar drugs.
We put together this guide to help you better understand what biologics and biosimilar drugs are and the differences between the two.
What are biologics?
Biologics are a class of prescription drugs that are made using living systems, such as microorganisms, plant cells, or animal cells. Since biologics come from diverse sources that can be hard to identify, they also tend to be more complex in their composition than conventional drugs. Even so, all biologics are regulated by the Food and Drug Administration (FDA).
What are biologics used for?
There are many complex conditions biologics have been approved to help treat. Some of these conditions include:
How are biologics different from traditional drugs?
Traditional pharmaceutical drugs are made from chemicals, whereas biologics come from living organisms. Thus they have a more complex structure, larger molecules, and are not easily reproduced by following a “chemical recipe“.
Examples of biologics
Biologics are usually administered by injection or infusion. This is due to the fact that if they are taken orally, the process of digestion would break down the biologic, likely making it ineffective.
Examples of biologics currently available include:
Biosimilar drugs are a very similar copy of the original FDA-approved biologic drug, known as the reference product. The biosimilar presents no significant differences in its safety or efficacy from the biologic product.
possibly lower health care costs through competition
Are biosimilars the same as generic drugs?
Unlike generic drugs, biosimilars are not identical copies of their reference drugs. However, each biosimilar drug is manufactured in a complex process that includes the exact steps made to make the biologic medication. Still, small changes are common from batch to batch since biosimilars are made from living cells.
These variations are expected and acceptable because every lot is still required to meet the same high standards of purity, safety, and efficacy as per the guidelines of the FDA.
Examples of biosimilar drugs
Like biologic drugs, biosimilars are also FDA-approved and only available with a prescription from a healthcare professional. Some examples of biosimilars include:
Differences between biologic and biosimilar drugs
A biosimilar is extremely similar to the biologic and has no significant clinically differences from another biologic already FDA-approved.
Have the same strength and dosage form as compared to the original biologic
Have the same possible side effects as the original biologic
Provide the same potential treatment benefits as the original biologic
As stated earlier, because there is no “chemical recipe” to follow when making biologics, biosimilars are generally made with the same natural sources as the reference product, but could have slight variations.
Biologics and biosimilar are some of the fastest-growing segments of the prescription product market. As the FDA continues to approve additional biosimilar medications, patients will have more treatment options and potentially less expensive alternatives.
You can access the FDA’s purple Book database for more information about biologic and biosimilar drugs.
Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder that causes weakness in the eyeballs and eyelids and progresses to the head, neck, limb, and respiratory muscles. Communication impairment between nerve cells and muscles prevents muscle contractions from occurring, resulting in muscle weakness.
According to the Myasthenia Gravis Foundation of America, MG is relatively rare, affecting only between 14 and 20 out of every 100,000 people in the United States. However, it’s the most common primary disorder of neuromuscular transmission.
While there is no cure for MG, a few different treatment options are available. Rituximab (Rituxan) is an infusion therapy prescribed for patients who don’t respond to other treatments. However, a newer IV treatment with monoclonal antibodies, Soliris (eculizumab), has become the first antibody-based complement inhibitor approved in the U.S., Europe, and Japan to treat adults suffering from generalized MG.
What are the symptoms of Myasthenia Gravis?
The main symptom of MG is weakness in the skeletal muscles (muscles under your control) which occurs due to the muscles not contracting normally. When the body’s muscles fail to contract, they can’t respond to nerve impulses leading to blocked communication between the nerve and muscle.
Weakness from MG typically gets worse when the body is more active and improves with rest. Other symptoms of MG include:
trouble talking/hoarse voice
problems walking up the stairs or lifting objects
difficulty breathing due to muscle weakness
drooping of eyelids
MG is a unique disease as not everyone will experience every symptom, and muscle weakness can change from day to day for each patient. Symptoms will most likely get more severe over time if left untreated.
What causes Myasthenia Gravis?
There are two leading causes of MG. Many people with MG have antibodies which instead of helping to fight off infections, viruses, and other threats to the body, mistakenly destroy, damage, or block acetylcholine receptors.Fewer receptors result in the muscles becoming weaker due to not contracting correctly.
In some cases, the immune system attacks other proteins, such as muscle-specific kinase, which is essential for helping to maintain the function of the neuromuscular junction.
While the specific cause of the abnormal autoimmune response is unknown, researchers believe that the thymus gland may help trigger or support the production of the harmful antibodies that interrupt nerve-muscle communication.
How Soliris works
By binding to the C5 protein, Soliris works by blocking and preventing the generation of the terminal complement cascade (TCC), a part of the immune system that consists of a series of reactions that trigger the adverse immune response.
Possible side effects of Soliris
As with any medication, there is a risk of side effects when taking Soliris. Common side effects include:
cold symptoms (stuffy nose, sneezing, or sore throat)
Although rare, serious side effects may occur. You should reach out to your doctor if you experience:
signs of infection (fever, persistent cough or sore throat, painful or frequent urination),
changes in the amount of urine output
Soliris is administered through an infusion, so you should let your doctor or nurse know if you experience the following symptoms during your treatment:
trouble breathing/shortness of breath
swelling of your face, tongue, or throat
feeling faint or like you may pass out
Soliris in clinical trials
Clinical trials of Soliris were done on adult MG patients who had two or more failed immunosuppressive treatments over 12 months and continued to suffer from significant unresolved disease symptoms.
Patients taking Soliris reported a 60% improvement in their quality of life. They also showed decreased symptoms, including improvement in their double vision, drooping of the eyelids, swallowing, speech, breathing, and muscle weakness.
While Soliris is not a cure for those living with MG, it has shown significant improvements in supporting improved functionality of MG patients as well as helping to treat and manage their symptoms that had not previously shown improvement with the use of previous treatments or medications.
Living with MG requires an individualized treatment plan that often includes medication, diet and lifestyle changes, and mental health care. Specialty Infusion Centers collaborate with your specialist to provide infusion therapy for MG based on your predetermined treatment plan. Our centers offer private suites, amenities, and flexible evening and weekend appointments. All you have to focus on is feeling better! Reach out to us to learn more or get started today.
Forgetting where you placed your car keys, calling a family member by the wrong name, or not remembering to grab milk at the grocery store are all common memory lapses that happen to most of us from time to time. However, if memory lapses become more frequent or affect your ability to do daily activities, you might be questioning if something else is going on, like Alzheimer’s.
It can be easy to explain unusual behavior and memory issues as part of the aging process, especially for someone who seems physically healthy. If someone you care about is experiencing signs of Alzheimer’s, being empowered with as much information as possible can help guide you through managing each stage of the disease and help you offer support to your loved one. We put together this guide to help you understand Alzheimer’s disease and the treatment options currently available.
What is Alzheimer’s Disease?
The CDC defines Alzheimer’s Disease as a progressive brain disease that causes memory loss and slowly destroys memory and thinking skills. Alzheimer’s may cause a person to become disoriented, get lost in familiar places, lose things frequently, or have trouble communicating.
Alzheimer’s disease is the most common type (60-80%) of dementia. Dementia is a syndrome that causes brain changes that continuously deteriorate cognitive, behavioral, and social skills. Ultimately, this loss of skills affects a person’s ability to function independently.
Statistics and facts about Alzheimer’s Disease
Some quick facts and statistics that are important to know about Alzheimer’s:
The life expectancy after initial diagnosis is between four to eight years. However, since the progression of the disease can vary, some people can live past 20 years.
Alzheimer’s disease impacts the parts of the brain that control our thought, memory, and language.
In 2020, around 6 million Americans were living with Alzheimer’s. That number is projected to hit at least 13 million by 2050.
1 out of every 3 seniors dies from Alzheimer’s. It’s the 6th leading cause of death in the senior population in the U.S.
The average age of diagnosis is 80 years old.
Early-onset or young-onset Alzheimer’s is a form of disease that affects people younger than age 65. Currently, it makes up 5% to 6% of people with Alzheimer’s disease.
Symptoms of Alzheimer’s get worse over time. However, this disease affects each person differently, so symptoms often vary.
Common symptoms include:
Change in moods and behavior (becoming more aggressive, agitated, or irritable)
Difficulty thinking or concentrating
Forgetting familiar places and people
Meaningless repetition of own words
Difficulty with self-care
Stages of Alzheimer’s Disease
Alzheimer’s disease typically progresses slowly in three general stages: early, middle and late (sometimes medically referred to as mild, moderate, and severe). Just as symptoms vary from person to person, so does each patient’s rate progresses through the disease stages.
Someone with Alzheimer’s has changes in their brain before they show any signs or symptoms. Referred to as the “preclinical” period of Alzheimer’s disease, this time can last for years.
Early/Mild stage of Alzheimer’s
In the early or mild stage of Alzheimer’s, a person may still function independently but experience memory lapses regarding recent conversations, events, and appointments.
Symptoms may not be obvious, but family and close friends may notice, and a doctor can identify signs using specific diagnostic tools.
Some challenges in the early stage include:
Coming up with the right word or name.
Remembering names when introduced to new people.
Having trouble completing tasks in social or work settings.
Trouble managing money
Not being able to recall recent reading material
Losing or misplacing valuables
Encountering an increased difficulty with planning or organizing
Middle/Moderate stage of Alzheimer’s
Typically the longest stage and can last for many years; the middle stage shows more noticeable symptoms. Someone in this stage often has trouble expressing thoughts and performing everyday tasks without assistance due to damage to the brain’s nerve cells. This can lead to them confusing their words, getting frustrated or upset, and acting out.
As Alzheimer’s progresses through the middle stage, the person will most likely require more frequent care.
Some challenges in the middle stage include:
Anxiety, agitation, and restlessness
Compulsive or repetitive behavior
Needing help with activities like dressing and bathing
Lose track of surroundings and time
Getting lost or wandering more frequent
Trouble with urine and bowel functions
In late stage Alzheimer’s, symptoms become severe. Those in the final stage lose the ability to respond to the environment around them, hold a conversation, and, ultimately, control their movement.
As a person’s memory and cognitive skills deteriorate, significant personality changes usually occur, and they eventually need extensive, around-the-clock care.
Some challenges in the late stage include:
Lose awareness of their surroundings
No ability to recall current events or conversations
A dramatic decrease in physical skills (walking, sitting, and swallowing)
Difficulty communicating/loss of ability to speak coherently
Increased risk of getting an infection, especially pneumonia
Treatment options available for Alzheimer’s Disease
There is no current cure for Alzheimer’s disease. However, researchers and scientists have made remarkable strides in understanding more about the disease.
Drugs that may impact the progression of Alzheimer’s disease
Medication that may temporarily alleviate some symptoms of Alzheimer’s disease
Drugs that treat symptoms
As Alzheimer’s disease progresses, cognitive symptoms worsen due to brain cells dying and lost connections among cells. It’s important to note that these drugs do not stop the damage to brain cells; instead, they can help lessen or better manage symptoms.
The following medications can help treat symptoms related to memory and thinking:
Alzheimer’s affects more than just memory and thinking; insomnia, agitation, aggression, anxiety, hallucinations, and delusions are also significant symptoms of the disease.
The FDA has approved one drug to address insomnia in people living with Alzheimer’s:
Anti-anxiety medications, anticonvulsants, and antipsychotics all have the risk of severe side effects for those with Alzheimer’s. Therefore they are usually prescribed for a short period of time and when symptoms become severe.
Drugs that treat the progression of Alzheimer’s
Currently, only one FDA-approved medication is authorized to treat the progression of Alzheimer’s disease, ADUHELM™(Aducanumab).
By targeting the fundamental pathophysiology of the disease, this new drug can help reduce amyloid plaques, slowing down the cognitive and functional decline of people living with early Alzheimer’s.
ADUHELM™ is administered to patients through 45 to 60-minute intravenous infusions (IV) once a month. The injection can be administered at hospitals or infusion therapy centers.
Resources for the caregiver
Becoming a caregiver for someone with Alzheimer’s can be physically, emotionally, mentalyl, and financially taxing. The demands of day-to-day care, changes in family roles, coping with the progression, and decisions about placement in a care facility can cause caregiver burnout quickly.
There are resources available to caregivers to empower and support them through this journey with their loved one. Here are some ways to find support and become well-informed about the disease:
Memory Cafe– Located in hospitals, libraries, senior centers, and other locations across the country, memory cafés support those with Alzheimer’s/dementia and their caregivers. Caregivers can find help battling social isolation and connect with others who are experiencing similar circumstances.
Good coping skills, a strong support system, respite care, and staying physically active are other ways caregivers can manage the stress of caring for a loved one with Alzheimer’s disease.
Some of the most exceptional developments in medical science in recent years have shed light on the devastating effects of Alzheimer’s disease to offer millions of patients hope. A better understanding of the disease’s impact may lead to better treatments. Ongoing clinical trials are allowing scientists to develop and test several possible interventions to hopefully, one day, address the underlying disease process.
As a result of the FDA’s approval of ADUHELM™, patients with Alzheimer’s disease now have a critical new treatment to help them potentially fight this challenging disease. At Specialty Infusion Centers, we provide the latest infusion and injection treatments, including ADUHELM™. Visit one of our conveniently located centers for all your infusion and injection needs.
If you take biologic medications like Remicade to treat a chronic inflammatory autoimmune condition, you’ve probably heard of biosimilars from your physician or other healthcare providers. Biosimilars can be complex to understand, leaving you with many questions.
We put together this comprehensive guide of common questions and answers to better understand the differences between Remicade and biosimilars.
(We always advise you to speak to your doctor before switching medications.)
What is a biologic medication?
Utilizing biotechnology, biologic medications are made from components that stem from human, animal or microorganism sources including sugars, proteins, DNA, whole cells, or tissue or other various elements of living things such as bacteria, birds, insects, mammals, and plants.
Since biologics come from diverse sources that can be hard to identify, they are more complex than conventional drugs. In addition, once these drugs are formed, they also tend to be more unpredictable in how they can take effect and are more sensitive to light and temperature.
With advances in the field of medicine, some biologics (gene-based and cellular) are now being used as treatments for many illnesses and diseases that may have previously otherwise had no treatment options available.
How do biologics work?
Depending on the disease and medication, biologics can:
Help manage the immune system’s signals involved in the inflammatory process that can lead to joint tissue damage
Target certain proteins that encourage inflammation, help cancer cells grow, or play a role in developing psoriasis.
Stimulate the immune system helping it work more effectively to fight infection
What is Remicade?
Remicade (infliximab) is a biologic prescription used to treat chronic inflammatory autoimmune diseases by reducing the effects of substances in the body that can cause inflammation. These conditions include:
This medication is given through intravenous infusions (IV), and dosage depends on the patient’s medical condition, weight, and response to treatment.
What are biosimilars?
Biosimilars are medications made using the same amino acid materials and specific processes as their reference drug. The reference drug refers to the well-tested, FDA-approved biologic drug that’s been on the market for years. The biosimilar presents with no significant differences in its safety or efficacy from the biologic product and is only available with a prescription from a healthcare professional.
possibly lower health care costs through competition
Are biosimilars the same as generic drugs?
No, they are not. Unlike generic drugs, biosimilars are not identical copies of their reference drugs. However, each biosimilar drug is manufactured by a complex process that includes the exact steps that were made to make the biologic medication.
While the same process is followed, small changes are common from batch to batch since biosimilars are made from living cells. These variations are expected and acceptable because every lot is still required to meet the same high standards of purity, safety and efficacy as per the guidelines of the FDA.
What are the biosimilars to Remicade?
There are currently 3 FDA-approved biosimilars to Remicade in the United States; Inflectra, Reneflexis, and Avsola.
Inflectra was the first biosimilar to Remicade, manufactured by Pfizer and released in April 2016. Renflexis was approved in April 2017 and Avsola was approved in December 2019, though it is unavailable.
All three biosimilars belong to the class of drugs called tumor necrosis factor (TNF) alpha inhibitors and work similarly to block TNF-alpha proteins that cause inflammation and swelling. Like Remicade, they are also given through an IV injection.
Inflectra, Renflexis, and Avsola are used to treat the same conditions as Remicade, including rheumatoid arthritis, Crohn’s disease, ankylosing spondylitis, ulcerative colitis, psoriatic arthritis, and plaque psoriasis.
These biosimilars are commonly used when other treatment options haven’t worked and can cost less than Remicade.
At this time, Inflectra, Renflexis, and Avsola aren’t considered “interchangeable” by the FDA, meaning a pharmacist can’t switch someone from a biologic to a biosimilar without a prescription from a physician/healthcare provider. If you are currently on Remicade, and it’s not working, you may want to speak with your doctor about biosimilar options.