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Simponi or Golimumab is a human monoclonal antibody. It is an immunosuppressive drug used for the treatment of autoimmune conditions like Rheumatoid Arthritis, active Ankylosing Spondylitis ( a type of arthritis which affects the spine), Psoriatic Arthritis, etc in adult patients. Simponi is used in these diseases either on its own, or in combination with the drug Methotrexate, which is a Dihydrofolate Reductase Inhibitor.

Simponi is also used in cases of Ulcerative Colitis, in patients who have become steroid dependent or in cases where there is insufficient response to corticosteroids, oral aminosalicylates, Azathioprine or 6-Mercaptopurine. Simponi helps by inducing and maintaining treatment as well as inducing and sustaining clinically apparent remission in patients.The mechanism of action of Simponi is that it is a TNF-alpha inhibitor. Tumor Necrosis Factor alpha is an inflammatory cytokine that is contributes to inflammation. Simponi is a human monoclonal antibody which effectively inhibits TNF.

Simponi standard dosages

Dosage of Simponi is a standard 50 mg dose administered subcutaneously, once a month. In Rheumatoid Arthritis it is prescribed in combination with Methotrexate. In Psoriatic Arthritis it can be given as per requirement with methotrexate, and DMARDs. In both these conditions, simultaneous oral corticosteroids and NSAIDs are also beneficial.

In Ulcerative Colitis, it is given in a standard regimen of 200 mg subcutaneously in the first week, 100 mg in the second week for induction of treatment, followed by 100 mg every 4 weeks as maintenance dose. Simponi is available as 50 mg and 100 mg SmartJect Autoinjectors, as well as in pre-filled syringes.

Simponi contra-indications

Simponi is contraindicated in patients with pre-existing bacterial and fungal infections, as it suppresses the immune response and this may cause the infection to worsen and spread to the whole body, as in tuberculosis, histoplasmosis or coccidioidiomycosis. Simponi should be used carefully in patients above 65 years of age and patients already on corticosteroid therapy, as well as pre-existing HIV or Hepatitis B infection. Especially with Hepatitis B and tuberculosis infections, reactivation of infection may occur.

Development of infections after starting Simponi can manifest as cough, muscle pain, fever, burning sensation during micturition or increased frequency of micturition, diarrhea and abdominal pain, etc. Rare cases of worsening of heart failure, Guillan Barre syndrome, skin cancer and Hodgkin’s Lymphoma have also been reported in some patients.

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