Biologics and Biosimilars

Biologics are the newest group of drugs approved for the treatment of moderate-to-severe psoriasis. These drugs are given by intravenous infusion or by injection under the skin (subcutaneous injection), and are usually prescribed to patients who have moderate-to-severe psoriasis who have failed or had adverse reactions to systemic therapy or an inadequate response to systemic therapy.  Some of these treatments are also effective in patients who also have psoriatic arthritis. Biologics work by blocking interactions between certain immune system cells and inflammatory pathways that are responsible for the signs and symptoms of psoriasis and psoriatic arthritis. Though these medications target only parts of the immune system, they can increase your susceptibility to an infection. If you are taking one of these medications, it is important that you be followed regularly by a dermatologist, rheumatologist or a physician who has expertise in the use of these medications.  

Biosimilars are biologic medications that are similar, but not identical, to an existing biologic drug. Marketed biosimilars have been demonstrated to be highly similar to a biologic drug that was already authorized for sale (known as the reference biologic drug). Biosimilars, however, are not the same as generic drugs. Generic drugs are small molecules that are chemically synthesized and are molecularly identical to their brand name reference products. Due to the size, complexity, and natural variability of biologic drugs, a biosimilar can be shown to be similar, but not identical to its reference biologic drug. A biosimilar is typically less expensive than its reference biologic product, and may be a suitable alternative for many patients. For more information visit Health Canada Biosimilar Biologic Drugs.

List of Medications (Psoriasis)

Click on a medication for additional information.

List of Medications (Psoriatic Arthritis)

Click on a medication for additional information.

How Biologics Work

The immune system is made up of many different parts. Biologics work by targeting specific parts of the immune system to decrease the body’s inflammatory response. They interfere with the immune system’s ability to communicate between certain types of cells by blocking specific protein(s).  Simply put, each class of biologics target a different part, or pathway, to decrease inflammation, reduce pain, and improve function. Currently, there are several different classes of biologics that target different pathways: TNF blockers, IL 17 blockers, IL 12/23 blockers, and IL 23 blockers. If one biologic does not work, or loses its efficacy, another biologic within the same class, or within a different class, may prove to be effective.

 

Etanercept (Enbrel®, biosimilar: Erelzi for Psoriatic Arthritis) (TNF Blocker)

How Does It Work?

Etanercept is a biologic that targets the overactive immune system in psoriasis. Etanercept works by supressing tumor necrosis factor-alpha (TNFa). Useful in psoriasis and psoriatic arthritis.

How Is It Used?

Etanercept is an injectable medication that is administered subcutaneously. This can be home dosed.

For plaque psoriasis:
50 mg twice weekly for 3 months, then 50 mg once weekly thereafter

For psoriatic arthritis: 
50 mg once weekly

What Are The Possible Side Effects?

The most common side effects of etanercept include temporary pain and redness around the injection site, and an increased risk of infection. To obtain a comprehensive list of all known potential side effects of etanercept, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on etanercept. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on etanercept.

Etanercept and other TNF inhibitory medications should be avoided in patients with or who have a close relative with multiple sclerosis. Etanercept should also be avoided in patients with severe heart failure. Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

Etanercept should be avoided in patients who are immunocompromised or HIV positive.

What Medications Interact With This Treatment?

Some medications that may interact with etanercept include denosumab, echinacea, and trastuzumab. For a complete list of medications that may interact with etanercept and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?
Enbrel®

British Columbia: S/A for psoriasis;  N, for psoriatic arthritis except for S/A exceptional coverage requests submitted before November 26, 2019, which will be considered on a case-by-case basis.
Alberta: Y* – S/A for plaque psoriasis and psoriatic arthritis
Saskatchewan: Y* – S/A for plaque psoriasis and psoriatic arthritis
Manitoba: Y* – S/A for plaque psoriasis and psoriatic arthritis
Ontario: L/U for psoriasis; S/A for psoriatic arthritis
Quebec: Y – S/A for plaque psoriasis and psoriatic arthritis
New Brunswick: Y – S/A for plaque psoriasis and psoriatic arthritis
Nova Scotia: Y* – S/A for plaque psoriasis and psoriatic arthritis
Prince Edward Island: Y – S/A for plaque psoriasis and psoriatic arthritis
Newfoundland and Labrador: Y – S/A for plaque psoriasis and psoriatic arthritis
Nunavut: Y – S/A for psoriatic arthritis
Northwest Territories: Y – S/A for psoriatic arthritis
Yukon: Y – S/A for plaque psoriasis

*For psoriatic arthritis only: S/A coverage for existing ENBREL patients that are well-controlled on therapy only. New S/A requests for etanercept-naïve patients will be approved for biosimilar versions only.

Erelzi

British Columbia: S/A for psoriatic arthritis
Alberta: S/A for psoriatic arthritis
Saskatchewan: S/A for psoriatic arthritis
Manitoba: S/A for psoriatic arthritis
Ontario: L/U for psoriatic arthritis
Quebec: N
New Brunswick: S/A for psoriatic arthritis
Nova Scotia: S/A for psoriatic arthritis
Prince Edward Island: S/A for psoriatic arthritis
Newfoundland and Labrador: S/A for psoriatic arthritis
Nunavut: S/A for psoriatic arthritis
Northwest Territories: S/A for psoriatic arthritis
Yukon: N

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Etanercept (Enbrel®): https://www.amgen.ca/products/patient-assistance/
Etanercept biosimilar (Erelzi): Call 1-844-27XPOSE (1-844-279-7673) for information

Adalimumab (Humira®) (TNF Blocker)

How Does It Work?

Adalimumab is a biologic that targets the overactive immune system in psoriasis. Adalimumab works by supressing tumor necrosis factor (TNFa). Useful for psoriasis and psoriatic arthritis.

How Is It Used?

Adalimumab is an injectable medication that is administered subcutaneously. This can be home dosed.

For plaque psoriasis:
80 mg as an initial dose, then 40 mg every other week starting one week after initial dose

For psoriatic arthritis:
40 mg every other week

What Are The Possible Side Effects?

The most common side effects of adalimumab include temporary pain and redness around the injection site, headaches, and an increased risk of infection. To obtain a comprehensive list of all known potential side effects of adalimumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on adalimumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on adalimumab.

Adalimumab and other TNF inhibitory medications should be avoided in patients with or who have a close relative with multiple sclerosis. Adalimumab should also be avoided in patients with severe heart failure. Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

Some medications that may interact with adalimumab include abatacept (Orencia®), anakinra (Kineret®) and other TNF-blockers such as Enbrel®, Remicade®, Cimzia®, or Simponi®. Adalimumab can potentially affect the speed at which cyclosporine and warfarin are metabolized and their doses may need to be adjusted. For a complete list of medications that may interact with adalimumab and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?

British Columbia: Y – S/A for plaque psoriasis and psoriatic arthritis
Alberta: Y – S/A for plaque psoriasis and psoriatic arthritis
Saskatchewan: Y – S/A for plaque psoriasis and psoriatic arthritis
Manitoba: Y – S/A for plaque psoriasis and psoriatic arthritis
Ontario: Y – S/A for plaque psoriasis and psoriatic arthritis
Quebec: Y – S/A for plaque psoriasis and psoriatic arthritis
New Brunswick: Y – S/A for plaque psoriasis and psoriatic arthritis
Nova Scotia: Y – S/A for plaque psoriasis and psoriatic arthritis
Prince Edward Island: Y – S/A for plaque psoriasis and psoriatic arthritis
Newfoundland and Labrador: Y – S/A for plaque psoriasis and psoriatic arthritis
Nunavut: Y – S/A for plaque psoriasis and psoriatic arthritis
Northwest Territories: Y – S/A for plaque psoriasis and psoriatic arthritis
Yukon: Y – S/A for plaque psoriasis and psoriatic arthritis

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Infliximab (Remicade®, biosimilars: Inflectra®, Renflexis®) (TNF Blocker)

How Does It Work?

Infliximab is a biologic that targets the overactive immune system in psoriasis. Infliximab works by supressing tumor necrosis factor-alpha (TNFa). Useful for psoriasis and psoriatic arthritis.

How Is It Used?

Infliximab is an injectable medication that is administered intravenously, useful for psoriasis and psoriatic arthritis. Typically this is done in an infusion centre.

For plaque psoriasis:
5 mg/kg at 0, 2, and 6 weeks, followed by 5 mg/kg every 8 weeks thereafter

For psoriatic arthritis:
5 mg/kg at 0, 2, and 6 weeks, followed by 5 mg/kg every 8 weeks thereafter.

What Are The Possible Side Effects?

The most common side effects of infliximab include temporary pain and redness around the infusion site, headaches, nausea, joint pain, and an increased risk of infection. To obtain a comprehensive list of all known potential side effects of infliximab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on infliximab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on infliximab.

Infliximab and other TNF inhibitory medications should be avoided in patients with or who have a close relative with multiple sclerosis. Infliximab should also be avoided in patients with severe heart failure. Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

Some medications that may interact with infliximab include cyclosporine, echinacea, phenytoin, and warfarin. For a complete list of medications that may interact with infliximab and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?
Remicade®

British Columbia: N, except for S/A exceptional coverage requests submitted before November 26, 2019, which will be considered on a case-by-case basis.
Alberta: Y* – S/A for plaque psoriasis and psoriatic arthritis
Saskatchewan: Y – S/A for plaque psoriasis and psoriatic arthritis
Manitoba: Y* – S/A for plaque psoriasis and psoriatic arthritis
Ontario: N
Quebec: Y – S/A for plaque psoriasis and psoriatic arthritis
New Brunswick: Y* – S/A for plaque psoriasis
Nova Scotia: Y* – S/A for plaque psoriasis and psoriatic arthritis
Prince Edward Island: Y – S/A for plaque psoriasis and psoriatic arthritis
Newfoundland and Labrador: Y* – S/A for plaque psoriasis
Nunavut: N
Northwest Territories: N
Yukon: Y* – S/A for plaque psoriasis and psoriatic arthritis

*S/A coverage for existing REMICADE patients that are well-controlled on therapy only. New S/A requests for infliximab-naïve patients will be approved for biosimilar versions only.

Inflectra®

British Columbia: S/A for plaque psoriasis and psoriatic arthritis
Alberta: S/A for plaque psoriasis and psoriatic arthritis
Saskatchewan: S/A for plaque psoriasis and psoriatic arthritis
Manitoba: S/A for plaque psoriasis and psoriatic arthritis
Ontario: L/U for plaque psoriasis and psoriatic arthritis
Quebec: S/A for plaque psoriasis and psoriatic arthritis
New Brunswick: S/A for plaque psoriasis and psoriatic arthritis
Nova Scotia: S/A for plaque psoriasis and psoriatic arthritis
Prince Edward Island: S/A for plaque psoriasis and psoriatic arthritis
Newfoundland and Labrador: S/A for plaque psoriasis and psoriatic arthritis
Nunavut: S/A for plaque psoriasis and psoriatic arthritis
Northwest Territories: S/A for plaque psoriasis and psoriatic arthritis
Yukon: S/A for plaque psoriasis and psoriatic arthritis

Renflexis®

British Columbia: S/A for plaque psoriasis and psoriatic arthritis
Alberta: S/A for plaque psoriasis and psoriatic arthritis
Saskatchewan: S/A for plaque psoriasis and psoriatic arthritis
Manitoba: S/A for plaque psoriasis and psoriatic arthritis
Ontario: L/U for plaque psoriasis and psoriatic arthritis
Quebec: N
New Brunswick: S/A for plaque psoriasis and psoriatic arthritis
Nova Scotia: S/A for plaque psoriasis and psoriatic arthritis
Prince Edward Island: S/A for plaque psoriasis and psoriatic arthritis
Newfoundland and Labrador: S/A for plaque psoriasis and psoriatic arthritis
Nunavut: N
Northwest Territories: N
Yukon: N

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Infliximab (Remicade®): https://www.bioadvancemember.ca/en/global/home
Infliximab biosimilar Inflectra®: https://www.pfizer.ca/assistance-programs
Infliximab biosimilar Renflexis®: https://www.merckharmony.ca/

Certolizumab pegol (Cimzia®) (TNF Blocker)

How Does It Work?

Certolizumab is a biologic that targets the overactive immune system in psoriasis. Certolizumab works by supressing tumor necrosis factor-alpha (TNFa).

Useful in psoriasis and psoriatic arthritis.

How Is It Used?

Certolizumab is an injectable medication that is administered subcutaneously.

For plaque psoriasis:
400 mg every 2 weeks

For psoriatic arthritis:
400 mg at weeks 0, 2, and 4, followed by 200 mg every 2 weeks

What Are The Possible Side Effects?

The most common side effects of certolizumab include joint pain, and an increased risk of  upper respiratory tract infections and urinary tract infections. To obtain a comprehensive list of all known potential side effects of certolizumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on certolizumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on certolizumab.

Certolizumab should be avoided in patients with moderate to severe heart failure.

Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

Some medications that may interact with certolizumab include denosumab, echinacea, and trastuzumab. For a complete list of medications that may interact with certolizumab and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?

British Columbia: Y – S/A for psoriatic arthritis
Alberta: Y – S/A for psoriatic arthritis
Saskatchewan: Y – S/A for psoriatic arthritis
Manitoba: Y – S/A for psoriatic arthritis
Ontario: Y – S/A for psoriatic arthritis
Quebec: Y – S/A for psoriatic arthritis
New Brunswick: Y – S/A for psoriatic arthritis
Nova Scotia: Y – S/A for psoriatic arthritis
Prince Edward Island: Y – S/A for psoriatic arthritis
Newfoundland and Labrador: Y – S/A for psoriatic arthritis
Nunavut: Y – S/A for psoriatic arthritis
Northwest Territories: Y – S/A for psoriatic arthritis
Yukon: Y – S/A for psoriatic arthritis

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Golimumab (Simponi®) (TNF Blocker)

How Does It Work?

Golimumab is a biologic that targets the overactive immune system in psoriatic arthritis. Golimumab works by supressing tumor necrosis factor-alpha (TNFa).

How Is It Used?

Golimumab is a biologic medication that can be administered either subcutaneously or intravenously.

What Are The Possible Side Effects?

The most common side effects of golimumab are an increased risk of infection and a temporary injection site reaction. To obtain a comprehensive list of all known potential side effects of golimumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on golimumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on golimumab.

Golimumab should be avoided in patients with severe heart failure.

Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

Some medications that may interact with golimumab include abatacept, anakinra, baricitinib, belimumab, canakizumab, certolizumab pegol, cladribine, echinacea, infliximab, leflunomide, natalizumab, pimecrolimus, rilonacept, roflumilast, tacrolimus, tocilizumab, tofacitinib, and vedolizumab. For a complete list of medications that may interact with golimumab and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?

British Columbia: Y – S/A for psoriatic arthritis
Alberta: Y – S/A for psoriatic arthritis
Saskatchewan: Y – S/A for psoriatic arthritis
Manitoba: Y – S/A for psoriatic arthritis
Ontario: Y – S/A for psoriatic arthritis
Quebec: Y – S/A for psoriatic arthritis
New Brunswick: Y – S/A for psoriatic arthritis
Nova Scotia: Y – S/A for psoriatic arthritis
Prince Edward Island: Y – S/A for psoriatic arthritis
Newfoundland and Labrador: Y – S/A for psoriatic arthritis
Nunavut: Y – S/A for psoriatic arthritis
Northwest Territories: Y – S/A for psoriatic arthritis
Yukon: Y – S/A for psoriatic arthritis

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Ixekizumab (Taltz®) (IL17 Blocker)

How Does It Work?

Ixekizumab is a biologic that targets the overactive immune system in psoriasis. Ixekizumab works by supressing interleukin-17A. Useful for psoriasis and psoriatic arthritis.

How Is It Used?

Ixekizumab is an injectable medication that is administered subcutaneously.

For plaque psoriasis:
160 mg once, followed by 80 mg at weeks 2, 4, 6, 8, 10 and 12, and then 80 mg every 4 weeks

For psoriatic arthritis:
160 mg once, followed by 80 mg every 4 weeks

What Are The Possible Side Effects?

The most common side effects of ixekizumab include temporary pain and redness around the injection site, and an increased risk of infection. To obtain a comprehensive list of all known potential side effects of ixekizumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on ixekizumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on ixekizumab.

Ixekizumab should be avoided in patients with currently active or previous history of inflammatory bowel disease.

Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

Some medications that may interact with ixekizumab include denosumab, echinacea, and trastuzumab. For a complete list of medications that may interact with ixekizumab and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?

British Columbia: Y – S/A for plaque psoriasis and psoriatic arthritis
Alberta: Y – S/A for plaque psoriasis and psoriatic arthritis
Saskatchewan: Y – S/A for plaque psoriasis and psoriatic arthritis
Manitoba: Y – S/A for plaque psoriasis and psoriatic arthritis
Ontario: Y – L/U for psoriasis; S/A for psoriatic arthritis
Quebec: Y – S/A for plaque psoriasis and psoriatic arthritis
New Brunswick: Y – S/A for plaque psoriasis and psoriatic arthritis
Nova Scotia: Y – S/A for plaque psoriasis and psoriatic arthritis
Prince Edward Island: Y – S/A for plaque psoriasis and psoriatic arthritis
Newfoundland and Labrador: Y – S/A for plaque psoriasis and psoriatic arthritis
Nunavut: Y – S/A for plaque psoriasis
Northwest Territories: Y – S/A for plaque psoriasis
Yukon: N

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Call 1-877-219-8908 for information.

Brodalumab (Siliq) (IL17 Blocker)

How Does It Work?

Brodalumab is a biologic that targets the overactive immune system in psoriasis. Brodalumab works by preventing interleukin-17 from causing inflammation.

How Is It Used?

Brodalumab is an injectable medication that is administered subcutaneously.

For plaque psoriasis:
210 mg at weeks 0, 1, and 2, followed by 210 mg once every 2 weeks

What Are The Possible Side Effects?

The most common side effect of brodalumab is an increased risk of infection. To obtain a comprehensive list of all known potential side effects of brodalumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on brodalumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on brodalumab.

Brodalumab should be avoided in patients with Crohn’s disease.

Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

Some medications that may interact with brodalumab include denosumab, echinacea, and trastuzumab. For a complete list of medications that may interact with brodalumab and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?

British Columbia: N
Alberta: N
Saskatchewan: Y – S/A for plaque psoriasis
Manitoba: Y – S/A for plaque psoriasis
Ontario: L/U for psoriasis 
Quebec: Y – S/A for plaque psoriasis
New Brunswick: Y- S/A for psoriasis
Nova Scotia: Y – S/A for plaque psoriasis
Prince Edward Island: Y – S/A for plaque psoriasis
Newfoundland and Labrador: Y – S/A for plaque psoriasis
Nunavut: N
Northwest Territories: N
Yukon: N

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Call 1-844-852-6967 for information.

Secukinumab (Cosentyx®) (IL17 Blocker)

How Does It Work?

Secukinumab is a biologic that targets the overactive immune system in psoriasis. Secukinumab works by supressing interleukin-17A. Useful for psoriasis and psoriatic arthritis.

How Is It Used?

Secukinumab is an injectable medication that is administered subcutaneously.

For plaque psoriasis:
300 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 300 mg every 4 weeks

For psoriatic arthritis:
For patients not treated previously by a biological agent – 150 mg (or 300 mg for some patients) once weekly at weeks 0, 1, 2, 3, and 4, followed by 150 mg every 4 weeks. For those with previous treatment with a biologic agent – 300 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 300 mg every 4 weeks.

What Are The Possible Side Effects?

The most common side effect of secukinumab is an increased risk of infection. To obtain a comprehensive list of all known potential side effects of secukinumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on secukinumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on secukinumab.

Secukinumab should be avoided in patients with currently active or previous history of inflammatory bowel disease.

Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

Some medications that may interact with secukinumab include denosumab, echinacea, and trastuzumab. For a complete list of medications that may interact with secukinumab and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?

British Columbia: Y – S/A for plaque psoriasis and psoriatic arthritis
Alberta: Y – S/A for plaque psoriasis and psoriatic arthritis
Saskatchewan: Y – S/A for plaque psoriasis and psoriatic arthritis
Manitoba: Y – S/A for plaque psoriasis and psoriatic arthritis
Ontario: Y – S/A for plaque psoriasis and psoriatic arthritis
Quebec: Y – S/A for plaque psoriasis and psoriatic arthritis
New Brunswick: Y – S/A for plaque psoriasis and psoriatic arthritis
Nova Scotia: Y – S/A for plaque psoriasis and psoriatic arthritis
Prince Edward Island: Y – S/A for plaque psoriasis and psoriatic arthritis
Newfoundland and Labrador: Y – S/A for plaque psoriasis and psoriatic arthritis
Nunavut: Y – S/A for plaque psoriasis and psoriatic arthritis
Northwest Territories: Y – S/A for plaque psoriasis and psoriatic arthritis
Yukon: Y – S/A for plaque psoriasis and psoriatic arthritis

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Ustekinumab (Stelara®) (IL12/23 Blocker)

How Does It Work?

Ustekinumab is a biologic that targets the overactive immune system in psoriasis. Ustekinumab works by suppressing interleukin 12 and interleukin 23. Useful for psoriasis and psoriatic arthritis.

How Is It Used?

Ustekinumab is an injectable medication that is administered subcutaneously. Can be home dosed.

For plaque psoriasis:
≤100 kg: 45 mg at 0 and 4 weeks, and then every 12 weeks thereafter
>100 kg: 90 mg at 0 and 4 weeks, and then every 12 weeks thereafter

For psoriatic arthritis:
45 mg at 0 and 4 weeks, and then every 12 weeks thereafter.

What Are The Possible Side Effects?

The most common side effect of ustekinumab is an increased risk of infection. To obtain a comprehensive list of all known potential side effects of ustekinumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on ustekinumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on ustekinumab.

Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

Some medications that may interact with ustekinumab include denosumab, echinacea, and trastuzumab. For a complete list of medications that may interact with ustekinumab and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?

British Columbia: Y – S/A for plaque psoriasis
Alberta: Y – S/A for plaque psoriasis
Saskatchewan: Y – S/A for plaque psoriasis and psoriatic arthritis
Manitoba: Y – S/A for plaque psoriasis
Ontario: Y – L/U for plaque psoriasis
Quebec: Y – S/A for plaque psoriasis and psoriatic arthritis
New Brunswick: Y – S/A for plaque psoriasis
Nova Scotia: Y – S/A for plaque psoriasis
Prince Edward Island: Y – S/A for plaque psoriasis
Newfoundland and Labrador: Y – S/A for plaque psoriasis
Nunavut: Y – S/A for plaque psoriasis
Northwest Territories: Y – S/A for plaque psoriasis
Yukon: Y – S/A for plaque psoriasis

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Risankizumab (Skyrizi) (IL23 Blocker)

How Does It Work?

Risankizumab is a biologic that targets the overactive immune system in psoriasis. Risankizumab works by supressing interleukin-23A.

How Is It Used?

The recommended dose of SKYRIZI is 150 mg (two 75 mg injections) administered by subcutaneous injection at Week 0, Week 4, and every 12 weeks thereafter. 

What Are The Possible Side Effects?

The most common side effect of risankizumab is an increased risk of infection. To obtain a comprehensive list of all known potential side effects of risankizumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on risankizumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on risankizumab.

Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

N/A

What Provinces and Territories List It On Formulary?

British Columbia: S/A for psoriasis; N for psoriatic arthritis
Alberta: S/A for psoriasis; N for psoriatic arthritis
Saskatchewan: S/A for psoriasis; N for psoriatic arthritis
Manitoba: S/A for psoriasis; N for psoriatic arthritis
Ontario: L/U for psoriasis; N for psoriatic arthritis
Quebec: S/A for psoriasis; N for psoriatic arthritis
New Brunswick: S/A for psoriasis; N for psoriatic arthritis 
Nova Scotia: S/A for psoriasis; N for psoriatic arthritis
Prince Edward Island: N
Newfoundland and Labrador: N
Nunavut: S/A for psoriasis; N for psoriatic arthritis 
Northwest Territories: S/A for psoriasis; N for psoriatic arthritis 
Yukon: S/A for psoriasis; N for psoriatic arthritis 

More information is available on S/A (special access) and L/U (limited use) at Special Access / Limited Use Designation Drugs.

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Guselkumab (Tremfya®) (IL23 Blocker)

How Does It Work?

Guselkumab is a biologic that targets the overactive immune system in psoriasis. Guselkumab works by supressing interleukin-23.

How Is It Used?

Guselkumab is an injectable medication that is administered subcutaneously.

For plaque psoriasis:
100 mg at weeks 0 and 4, and then every 8 weeks thereafter

What Are The Possible Side Effects?

The most common side effect of guselkumab is an increased risk of infection. To obtain a comprehensive list of all known potential side effects of brodalumab, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on guselkumab. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on guselkumab.

Patients should be screened for tuberculosis and some invasive fungal infections prior to treatment.

What Medications Interact With This Treatment?

N/A

What Provinces and Territories List It On Formulary?

British Columbia: N
Alberta: N
Saskatchewan: N
Manitoba: N
Ontario: N
Quebec: N
New Brunswick: N
Nova Scotia: N
Prince Edward Island: N
Newfoundland and Labrador: N
Nunavut: N
Northwest Territories: N
Yukon: N

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Abatacept (Orencia®)

How Does It Work?

Abatacept is a biologic that targets the overactive immune system in psoriatic arthritis. Abatacept works by supressing the activation of white blood cells called T-cells.

How Is It Used?

Abatacept is a biologic medication that can be administered either subcutaneously or intravenously.

What Are The Possible Side Effects?

The most common side effects of abatacept are headache, nausea, and an increased risk of infection. To obtain a comprehensive list of all known potential side effects of abatacept, talk your doctor or pharmacist.

Any Other Important Considerations?

Some vaccinations, known as live vaccinations, should be avoided while on abatacept. Before receiving a vaccination, ask your healthcare provider if the vaccine is ok to receive while on abatacept.

Patients with chronic obstructive pulmonary disease (COPD) are at an increased risk of experience COPD-related adverse events such as cough, shortness of breath, and infection while on abatacept.

Abatacept should be avoided in patients who are immunocompromised or HIV positive.

What Medications Interact With This Treatment?

Some medications that may interact with abatacept include anakinra, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, baricitinib, belimumab, cladribine, echinacea, leflunomide, natalizumab, pimecrolimus, rituximab, roflumilast, tacrolimus, tocilizumab, and tofacitinib. For a complete list of medications that may interact with abatacept and to understand how a potential drug interaction should be managed, talk to your doctor or pharmacist.

What Provinces and Territories List It On Formulary?

British Columbia: N
Alberta: N
Saskatchewan: N
Manitoba: N
Ontario: N
Quebec: N
New Brunswick: N
Nova Scotia: N
Prince Edward Island: N
Newfoundland and Labrador: N
Nunavut: N
Northwest Territories: N
Yukon: N

This site is updated regularly; however this is information is subject to change.  For the most up-to-date information regarding your specific province / territory click here.

Last updated October 28, 2019.

Disclaimer

This Site was designed for educational purposes only and not for the purpose of rendering medical advice. Individual variances in psoriasis cases require the consultation of a physician to make sound medical decisions. The information presented on this website is not intended to replace the counsel of your physician. It is important to see your doctor before altering anything in your treatment plan. The Canadian Psoriasis Network does not endorse any medications, products, equipment or treatments for psoriasis and psoriatic arthritis. Any of the information contained within the Canadian Psoriasis Network’s Site is not presented as a substitute for informed medical advice. Visitors to this site should not engage in self-diagnosis nor act on information contained in the Site without seeking specific advice on the particular matters which are of concern to them from qualified health professionals and advisors. Some of the information contained in the Site has been provided from external sources. While efforts have been made to ensure the accuracy, currency, and reliability of the content, the Canadian Psoriasis Network accepts no responsibility in that regard. Please refer to our Terms of Use for further details.

This resource was made possible through support from:
Abbvie
Pfizer
Janssen
Bausch
 
LEO Pharma
Novartis
Amgen

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