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tsitodawg
Veteran Member


Date Joined Sep 2006
Total Posts : 845
   Posted 5/21/2008 10:45 PM (GMT -7)   
I

Post Edited (tsitodawg) : 11/12/2011 5:22:25 PM (GMT-7)


ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 5/22/2008 9:36 AM (GMT -7)   

tsitodawg, I am currently finishing up a clinical trial for Cimzia.  I started it over a year ago after stopping Remicade due to allergic reactions and lose of response. Cimzia is similar to Humira but, from what I've been told and researched, has no mouse proteins (Humira has a small amount).  Cimzia helped with the stomach pain and some with the arthritis pain (I've never had D with my Crohn's, so the stomach and joint pain were my biggest complaints).  But, once winter got here, the joint pain got worse and, while the Cimzia helped, it didn't help enough to keep me from having to take arthritis and pain meds also (which caused 3 ulcers and forced me to have to stop taking the arthritis meds). 

So, now the trial is ending since the FDA approved Cimzia and Tuesday will be my last injections.  Instead of continuing to get the drug on the market, my GI wants to try Humira to see if that will help more with the joint pain and prevent me from having to take pain meds each day.  My only concern with Humira is that there is still some foreign proteins and it sounds like a lot of people have reactions to it and get rashes, itch, etc.  The only problem I ever had with Cimzia was a reaction site whelp (and I got the worst reaction of anyone on my particular trial).  So, I will try Humira but may have to go back to Cimzia if my body doesn't like the small amount of foreign protein. 

Anyway, I'm thankful that I got on the trial and have had a much better year due to it.  If you've had problems with Remicade, definitely give Cimzia a shot. 


...rejoice in our sufferings, because we know that suffering produces perseverence; perseverence, character; and character, hope.   Romans 5:3-4


Illini
Regular Member


Date Joined Dec 2007
Total Posts : 298
   Posted 5/22/2008 10:18 AM (GMT -7)   
I looked more carefully and it's way too convoluted. I don't know for certain which is more/less human confused See below

Both are antibodies...so they are made of protein. But human/mouse/basically all mammalian cells "decorate" their proteins with sugars (the terms is glycosylation). In general those sugars help to prevent the body from recognizing the drug as foreign. So they help to prevent an immune response against the drug. The sugars also prolong the half-life of the drug in your body.

Humira is made in mammalian cells, so it is glycosylated. It was "engineered" so it's not 100% similar to any natural human antibody, but still, it's human-derived.

Cimzia is made in bacteria, so it is not decorated with sugars. Bacteria don't have the machinery to do it. So instead the makers of Cimzia attached a compound called polyethylene glycol to the antibody. That helps to lower the immunogenicity and also prolongs the half-life in the body. Both strategies work. Based on the manufacturing method Cimzia ought to be less expensive, but I don't know the actual numbers.


July 2007 Drug-Induced Liver Injury
January 2008 Crohn's Ileitis
Currently trying...
Enteral Nutrition, Omega-3 (Flax Oil and Fish Oil), VSL#3, Vitamin E, Folic Acid, Psyllium

Post Edited (Illini) : 5/22/2008 12:01:21 PM (GMT-6)


ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 5/22/2008 10:27 AM (GMT -7)   
Illini,
 
Wow, that was way too technical for me.  =)  You could be completely correct...my clinical trial coordinator is the one who told me that Humira has about 5% mouse/foreign protein.  You said Humira is made in mammalian cells...do you know what mammal?  Maybe that is where the mouse comes in.  Or maybe the Cimzia manufacturer gave my clinical trial coordinator incorrect information about Humira.  Either way, I'm hoping I don't have a reaction to it, as it sounds like a lot of people do have reactions and I'm extremely sensitive to drugs.   
...rejoice in our sufferings, because we know that suffering produces perseverence; perseverence, character; and character, hope.   Romans 5:3-4


Illini
Regular Member


Date Joined Dec 2007
Total Posts : 298
   Posted 5/22/2008 10:55 AM (GMT -7)   

So here's what I found:

"Certolizumab has been constructed by grafting the short hypervariable complementarity-determining regions derived from the murine monoclonal antibody HTNF40 onto an otherwise virtually human Ig Fab′ fragment" GASTROENTEROLOGY 2005;129:807–818

So I think all that's saying is that the part of Cimzia that actually recognzies TNF is mouse-based.

Then looking further into Humira:

"Unlike infliximab, adalimumab contains no nonhuman sequences, making it indistinguishable in structure and function from naturally occurring human IgG1." Reference: http://dermatology.cdlib.org/122/case_reports/adalimumab/hsu.html

But Humira was made by fusing human and mouse components together, and later separating out the "human" parts and combinging them together to make something "fully human." Did a little bit of mouse get left behind? I don't know. The same paper says that 5% of rheumatoid arthritis patients treated with Humira develop a reaction. Maybe that's where the 5% comes from? Reference: Molecular Interventions 3:310-318 (2003)

Regarding how the drugs are made (now don't get freaked out!) that same paper above says:

"...inserted into an appropriate mammalian cell line––Chinese hamster ovary cells in the case of adalimumab [Humira]––for production."


July 2007 Drug-Induced Liver Injury
January 2008 Crohn's Ileitis
Currently trying...
Enteral Nutrition, Omega-3 (Flax Oil and Fish Oil), VSL#3, Vitamin E, Folic Acid, Psyllium


ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 7/18/2008 9:51 AM (GMT -7)   
Here's an old post on the Cimzia/Humira mouse protein question. 
Crohn's Disease, Acid Reflux/Gastritis, Hashimoto's Thyroiditis, Endometriosis, Arthritis, Depression/Anxiety.  Too many meds to list them all.  =) 


gachrons
Veteran Member


Date Joined Mar 2007
Total Posts : 4527
   Posted 7/18/2008 5:32 PM (GMT -7)   
Glad to hear you have renewed hope and that your GI is looking after you . lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,and still alive.lol gail


CrohnieYogi
Regular Member


Date Joined Oct 2006
Total Posts : 367
   Posted 7/18/2008 7:48 PM (GMT -7)   

Wow!  There's so much in this thread! 

Tsitodawg--it's great to hear you've found someone who listens to you.  Most people (me included) went to the first GI and thought that doctor should have all the answers on CD.  Unfortunatly, most of the docs out there only have a couple of CD patients and don't really know the basics.  That is why it is so important DO NOT BE AFRIAD to shop around for a doctor.

As for the mouse versus human component, I was hung up on that for awhile, too.  But I went to an educational program and asked the doctor about this.  The answer went something like this, "anything we put in our bodies is foreign to our body.  Even if I have a kidney transplant (which is human) my body would try to resist.  Therefore, it doesn't matter if there is a mouse component."

I also asked about the pegylation and it was said that it makes the drug stay in the body longer and I think he said it made it safer.


ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 7/21/2008 9:28 AM (GMT -7)   
I will be asking my doctor about it this week, as I had an injection site reaction to the Humira last week that I never had to the Cimzia.  I used to get a white whelp or bruise sometimes with the Cimzia, but I got a red really itchy whelp from the Humira.  It itched for a few days and is gradually going away.  This is even with me taking two benedryl's a day for the last week and a half!  So, I hope it doesn't get any worse and that they don't make me stop it yet because of this. 
Crohn's Disease, Acid Reflux/Gastritis, Hashimoto's Thyroiditis, Endometriosis, Arthritis, Depression/Anxiety.  Too many meds to list them all.  =) 


ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 7/21/2008 5:12 PM (GMT -7)   
Great information, folks! I've added it to the new meds thread.

Thanks,

I.
Co-Moderator Crohn's Forum.


Jack from SF
New Member


Date Joined Dec 2008
Total Posts : 10
   Posted 12/30/2008 11:08 AM (GMT -7)   
The cost of Cimzia is $1350 a dose, according to my insurance.
Taking Cimzia and prednisone.


survivor49
Regular Member


Date Joined Oct 2007
Total Posts : 241
   Posted 1/1/2009 11:55 AM (GMT -7)   
zena
if the situation were reversed, i would want you to tell me this-
"whelp" means to have puppies
i think that you mean "welt" which is another word for hive
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