Golimumab (Simponi)
Simponi (golimumab) is a biologic medicine that helps treat the pain and swelling of arthritis.
Simponi is used in the treatment of Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Ulcerative Colitis, and other types of arthritis.
Simponi belongs to a class of similar medications called Anti-Tumor Necrosis Factor (Anti-TNF) agents. These medications work by blocking Tumor Necrosis Factor (TNF), a type of signalling protein called a cytokine that is involved in systemic inflammation.
Simponi may be prescribed in combination with other medications like methotrexate.
Taking Simponi
Simponi is available as a monthly subcutaneous (under the skin) injection called Simponi SC, and an IV infusion called Simponi IV.
Simponi can take about 2 weeks before patients start to feel its effects. Some patients notice a benefit shortly after their first dose, while in others it can take several weeks. It can take 4 to 12 weeks before patients feel a lot of benefit.
The normal dose for the Simponi SC injection is 50 mg. It is taken monthly.
Watch our video to learn how inject Simponi SC quickly at home:
Learn how to inject subcutaneous injectionsLearn how to inject autoinjectorsSubcutaneous injections (under the skin injections) are easy to do compared to other types of injections. A small needle pokes just under the skin to deliver medicine into the “fatty tissue” below.
The Simponi IV infusion is done in a specialized clinic by a trained nurse. Infusions take about 30 minutes.
The normal dose for the Simponi IV infusion is 2 mg per kilogram of body weight. Patients start by receiving an initial infusion, followed by a second infusion 4 weeks later. After that, patients receive infusions every 8 weeks.
The manufacturer of Simponi offers a support program to Canadian patients that are prescribed the medication:
Patient support program enrolment formsImportant Tests and Risks
Simponi can make it a bit harder for people to fight off infections.
Patients taking this medicine should call their doctor if they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection.
Patients should coordinate with their doctor to stop treatment before any surgery, and re-start once things have healed and there’s no sign of infection. Most patients stop the medication a month before surgery. It can be restarted 10-14 days after the surgery as long as there is no sign of infection.
Patients should discuss all vaccinations with their doctor because some (live vaccines) are not advisable to get while taking Simponi.
All patients should have a tuberculosis skin test done and get a chest x-ray before starting treatment.
Patients who are taking Simponi should have occasional blood tests as requested by their doctor to keep track of their arthritis and make sure the blood counts are ok.
Science
In some people with arthritis, a signalling protein (cytokine) called Tumor Necrosis Factor (TNF) is present in the blood and joints in excessive amounts where it increases inflammation (pain and swelling).
Simponi (golimumab) is another type of protein (specifically: a monoclonal antibody) called a Tumor Necrosis Factor blocker. It blocks the action of Tumor Necrosis Factor. In blocking Tumor Necrosis Factor, Simponi suppresses the body’s immune system. Though this suppression can make it slightly harder for patients to fight off infections, it also helps to stabilize an overactive immune system.
In patients with arthritis, this medicine can:
- Reduce the pain and swelling (inflammation) in arthritic joints
- Improve day to day function
- Prevent long-term damage caused by joint inflammation
Safety
Patients should talk to their doctor if they are concerned about any side effects.
All fevers and infections should be reported to a doctor. Occasional blood tests are important so doctors can monitor patients’ liver and blood counts.
MORE COMMON side-effects include:
- Injection site reaction: Some patients may react to the medication during or shortly after and infusion.
- Upper respiratory tract infections (such as sinusitis)
RARE side-effects include:
- Infection – There is an increased risk of serious infection. Any infections or fevers should be taken seriously and reviewed by a doctor
- Nervous System – There have been rare reports of some patients developing disorders that affect the nervous system (multiple sclerosis, seizures, or inflammation of the nerves of the eye) while taking medications like Simponi. Fortunately, these reports are exceedingly rare.
- Heart – Patients should inform their doctor if they have congestive heart failure as Simponi may make it worse.
- Blood Counts – Simponi can cause a drop in the numbers of white blood cells (which are needed to fight infection) or red blood cells (which carry oxygen). This is very rare and it is unusual for this to be a serious problem. Patients should get occasional blood tests so their doctor can monitor their liver and blood counts.
- Malignancy – When used for long periods of time, Simponi may be associated with a small increased risk of cancer, however, the data is not entirely clear.
How to minimize the side-effects of Simponi:
- Patients should take Simponi as prescribed by their doctor.
- Stay on top of regular blood tests
Simponi should not be taken with other biologic medications or JAK inhibitors.
Patients who should NOT be taking Simponi (golimumab) include:
- Patients who have had a previous serious allergic reaction to Simponi (golimumab)
- Patients taking other biologics or JAK inhibitors
- Possibly patients who have cancer or have had a past history of certain cancers
- Patients who have congestive heart failure
- Patients who have Lupus or multiple sclerosis
- Patients with active infections (such as tuberculosis)
People taking Simponi should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.
Other reasons to call a doctor while taking Simponi include:
- Fever, infection, or suspected infection
- If another doctor has prescribed antibiotics to fight an infection
- Upcoming surgery
- Pregnancy or planning on pregnancy
- Planning on getting a vaccination
- Development of a rash
Anyone who becomes pregnant while taking Simponi should notify their doctor.
Pregnancy and medicationsVideo
Watch Canadian rheumatologist Dr. Andy Thompson introduce Simponi in this short video:
Resources
DIN
- 02324776 (IV)
- 02324784 (SC)
- 02324776(SC)