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Simponi (also referred to by its generic name, golimumab) is a biologic medication that is used to treat psoriatic arthritis.
How does Simponi work?
Simponi blocks tumour necrosis factor-alpha (TNF alpha) a chemical ‘messenger’ in the immune system that signals other cells to cause inflammation. There is too much TNF alpha in the joints of people with psoriatic arthritis, which causes inflammation and can lead to tissue and joint damage. TNF alpha can also lead to increased activity of the immune system by switching on certain white blood cells in the body, called T Cells. Once T cells become overactive they can trigger inflammation and other immune responses, encouraging the development of psoriatic arthritis.
Simponi helps lower the amount of TNF alpha to more normal levels, and switches off the inflammatory cycle of psoriatic arthritis. This leads to improvement in symptoms for many people who take it.
Who is Simponi for?
Simponi can be prescribed to treat active and ‘progressive’ (worsening) psoriatic arthritis if other disease-modifying anti-rheumatic drugs have not worked. This means that if you have taken systemic treatments such as methotrexate, sulfasalazine or leflunomide for your psoriatic arthritis without a good response, you could be offered Simponi.
Who should not take Simponi?
- People with active infections should not start Simponi. You will be tested to check for infections before starting treatment.
- In most cases, pregnant women should not be treated with Simponi and women should not breastfeed during treatment with Simponi. Women should not fall pregnant or breast feed for six months after treatment has stopped.
- Simponi should be used with caution in people with multiple sclerosis or other similar types of demyelinating (destruction of nerve tissue) neurological diseases. Your Rheumatologist should discuss this with you, if relevant.
- Simponi should also be used with caution in elderly people, those with already impaired immune systems, or a history of heart failure or cancer. Again, your Rheumatologist will discuss this with you, if relevant.
- People with a latex allergy – the needle cover on the pre-filled pen is manufactured from dry natural rubber containing latex, and may cause allergic reactions in individuals sensitive to latex.
How is Simponi used?
Individuals take Simponi at home by giving themselves an injection under the skin via a pre-filled ‘pen’ device. Most people will be trained by a nurse to give the injection to themselves. Simponi is taken once a month, on the same date every month. Simponi can be prescribed by itself or is sometimes used in combination with methotrexate.
People taking Simponi will have regular blood tests every three to six months- usually carried out by Dermatology Nurses, or by their own GP- to monitor for infections or other possible effects of the treatment. People taking Simponi should have an annual flu jab, but should check with a doctor or nurse before having any other vaccinations or taking other medication.
What are the side effects of Simponi?
As with all medications, some side effects are possible when taking Simponi. It is important to remember that not every person taking a medication will get all, or even any, of the possible side effects listed. Many side effects of Simponi are mild and do not cause most patients to stop taking it.
The most common side effects for people taking Simponi include upper respiratory tract infections such as laryngitis and rhinitis, high blood pressure, dizziness and headache, anaemia, itching and rashes. Because Simponi works by suppressing part of the activity in the immune system, it can make people taking it more prone to infections than they usually would be. If a serious infection occurs a doctor will most likely stop Simponi.
Although side effects are possible with this, and any, treatment, it is important to remember that people taking Simponi have regular blood tests to check for health issues. If you are worried about the side effects of Simponi, you should discuss these with your doctor.
How long will Simponi take to work?
It can take a number of weeks before a person’s psoriatic arthritis improves on Simponi. If considerable improvement is not seen in three months, treatment with Simponi will be stopped. If this happens, a Dermatologist should discuss the next available options with you - there are a number of other biologic or systemic treatments that can be tried if Simponi does not work.
How safe and effective is Simponi?
Biologic medications have been used to treat psoriasis in the UK for a number of years and, although those currently in use are thought to be safe, it is important to note that long term safety data is still being compiled by the British Association of Dermatologists Biologics Interventions Register (BADBIR). The National Institute for Health and Care Excellence (NICE) recommends that all patients receiving biologic therapy, who provide their consent, are entered onto this observational study register.
The information on this page is also available in our Simponi (golimumab) information sheet.