Otezla vs. Humira for Plaque Psoriasis and Psoriatic Arthritis: Important Differences and Potential Risks.

Key takeaways

Otezla (apremilast) and Humira (adalimumab) are both medications used to treat plaque psoriasis and psoriatic arthritis, but they have some important differences. Otezla is a phosphodiesterase-4 (PDE-4) inhibitor taken by mouth twice daily, while Humira is a biologic disease-modifying antirheumatic drug (DMARD) injected under the skin, usually every other week. Otezla is also approved for mouth sores from Behçet’s disease, whereas Humira is used for a wider range of autoimmune conditions, including rheumatoid arthritis, Crohn's disease, and ulcerative colitis. Otezla requires a gradual increase in dosage to minimize side effects like nausea and diarrhea. Generic versions of Otezla are FDA-approved but not yet available, whereas Humira has several biosimilars. Common side effects of Otezla include diarrhea and nausea, while Humira can cause injection-site reactions and increase the risk of infections. Additionally, Humira may raise the risk of lymphoma and skin cancer and cannot be used with live vaccines.

Otezla

(apremilast)

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Humira

(adalimumab)

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Summary for Otezla

Prescription only

Otezla (apremilast) is a tablet that's taken by mouth. It treats plaque psoriasis and psoriatic arthritis in people 6 years and older. The medication can also treat mouth sores from Behçet’s disease in adults. It works as a phosphodiesterase-4 (PDE4) inhibitor to reduce inflammation. Immediate-release tablets called Otezla are taken twice daily. You start at a low dose, then it gets raised over a few days to a maintenance dose. Some people can switch to once-daily, extended-release tablets called Otezla XR. Side effects include nausea and diarrhea.

Indications for Otezla

Psoriatic arthritis in people 6 years and older
Plaque psoriasis in people 6 years and older
Mouth sores from Behçet’s disease in adults

Pros and Cons for Otezla

Pros

Taken by mouth
Can take with or without food
Option to switch to once-daily extended-release tablets for some people

Cons

Dosing schedule can be confusing in the beginning
Common to have nausea or diarrhea when starting
Might not be a good option for people who've had depression or suicidal behavior

Common Side Effects for Otezla

Diarrhea (17%)
Nausea (17%)
Upper respiratory tract infection (e.g., common cold; 9%)
Headache (up to 8%)

Warnings for Otezla

Allergic reaction
Diarrhea, nausea, and vomiting
Depression
Possible weight loss
Drug interactions

Summary for Humira

Prescription only

Humira (adalimumab) is an injection used to treat many different autoimmune conditions like rheumatoid arthritis, Crohn's disease, ulcerative colitis, and plaque psoriasis. As a TNF blocker, the medication works by blocking a protein that causes inflammation in your body. It's given as a shot under the skin once every 1 to 2 weeks, depending on your condition. Humira (adalimumab) doesn't have a true generic, but there are several similar versions called biosimilars. Common side effects include infections, injection site reactions, and headache.

Indications for Humira

Rheumatoid arthritis (RA) - adults only
Juvenile idiopathic arthritis (JIA) - people age 2 and older
Psoriatic arthritis (PsA) - adults only
Ankylosing spondylitis (AS) - adults only
Crohn's disease (CD) - people age 6 and older
Ulcerative colitis (UC) - people age 5 and older
Plaque psoriasis - adults only
Hidradenitis suppurativa (HS) - people age 12 and older
Uveitis - people age 2 and older

Pros and Cons for Humira

Pros

Can be used for many autoimmune conditions
Available as a ready-to-use pen that makes it easier to self-inject at home
Can be used in young children (as young as 2 years old for some conditions)
Only needs to be injected a couple times a month
Can be left at room temperature for up to 14 days if needed

Cons

Raises the risk of serious infections
Can take a few weeks or longer to work
Might be difficult to inject for some people
Can't receive any live vaccines while taking the medication
Might contain rubber or latex, which can cause a reaction for those with an allergy

Common Side Effects for Humira

Injection-site reaction (20%)
Upper respiratory tract infection (17%)
Headache (12%)
Rash (12%)
Sinus inflammation (11%)
Accidental injury (10%)
Nausea (9%)
Urinary tract infection (UTI) or bladder infection (8%)

Note: The side effects listed above were reported by adults with rheumatoid arthritis and are similar to those seen in people using Humira (adalimumab) for other conditions.