Stelara vs. Humira: What You Should Know

Introduction

If you have an autoimmune or inflammatory condition, your doctor may talk to you about treating it with Stelara (ustekinumab) or Humira (adalimumab).

Stelara and Humira are brand-name prescription drugs used in adults and in some children. Both are also injectable biologic drugs. A biologic is made from parts of living organisms.

Biosimilars aren’t yet available for either drug. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.)

Even though Stelara and Humira are alike, they have differences, too. Read on to learn more about how these drugs compare.

Note: For more information about these drugs, visit our Stelara and Humira articles.

What are the ingredients in Stelara and Humira?

Stelara and Humira are both monoclonal antibodies. Monoclonal antibodies mimic the effects of proteins made by your immune system.

• Stelara contains the monoclonal antibody ustekinumab. Ustekinumab belongs to a drug class* called interleukin-12 and interleukin-23 blockers.
• Humira contains the monoclonal antibody adalimumab. Adalimumab belongs to a drug class* called tumor necrosis factor (TNF) blockers.

Stelara and Humira both belong to a broader class* called disease-modifying antirheumatic drugs (DMARDs). DMARDs suppress the immune system to lower inflammation (swelling and damage).

* Drug classes are drugs grouped together by how they work or their uses.

What are Stelara and Humira used for?

Stelara and Humira are used to treat the active autoimmune and inflammatory conditions listed here. “Active” means you have inflammation (swelling and damage) and symptoms. These uses are for adults. For uses in children, see the sections that follow.

• moderate to severe plaque psoriasis when phototherapy or systemic treatments may help
• psoriatic arthritis*
• moderate to severe Crohn’s disease
• moderate to severe ulcerative colitis (UC) when other treatments haven’t helped enough

* For this use, Stelara or Humira may be used alone or with another disease-modifying antirheumatic drug (DMARD).

Additional factors may determine whether Stelara or Humira is right for your condition. For example, Humira is used for plaque psoriasis when other treatments aren’t good options.

Humira is used to treat other active autoimmune and inflammatory conditions in adults. These include:

• moderate to severe rheumatoid arthritis
• ankylosing spondylitis
• moderate to severe hidradenitis suppurativa
• certain kinds of uveitis

Stelara and children

Stelara is used to treat moderate to severe plaque psoriasis in children ages 6 years and older. For this use, a child must be able to have phototherapy or systemic treatments to help their condition.

Humira and children

Humira is used to treat certain autoimmune or inflammatory conditions in children, including:

• moderate to severe juvenile idiopathic arthritis (JIA) in children ages 2 years and older*
• moderate to severe Crohn’s disease in children ages 6 years and older when other treatments haven’t helped enough
• moderate to severe hidradenitis suppurativa in children ages 12 years and older
• certain kinds of uveitis in children ages 2 years and older

* For JIA, Humira may be used with or without another DMARD.

What is the cost of Stelara and Humira?

Whether you have health insurance or not, cost may be a factor when you’re considering these drugs.

Keep in mind that what you’ll pay for either drug will depend on your treatment plan, health insurance, and the pharmacy you use. It may also depend on the cost of any visits to your healthcare provider to receive doses of Stelara or Humira.

Stelara and Humira are both brand-name biologic drugs. Biologic drugs don’t have generic versions. However, some have biosimilar versions.

Biosimilars are medications that are similar to original brand-name biologics.

Generics are exact copies of brand-name drugs. Biosimilars, on the other hand, have the same active ingredients as the parent biologic but aren’t exactly the same. However, biosimilars are considered to be as safe and effective as brand-name biologics.

Like generics, biosimilars usually cost less than their brand-name parent drugs.

Stelara and Humira don’t yet have biosimilars available.

FAQs about Stelara and Humira

Get answers to some frequently asked questions about Stelara and Humira.

Are Stelara and Humira used to treat ulcerative colitis?

Yes, both Stelara and Humira are treatment options for ulcerative colitis (UC). This is a type of inflammatory bowel disease (IBD).

Both drugs can help adults with active moderate to severe UC achieve and maintain remission. “Active” means you have inflammation (swelling and damage) in your large intestine that’s causing UC symptoms. “Remission” means the inflammation is controlled and not causing symptoms.

Stelara and Humira are also used to treat moderate to severe Crohn’s disease, another IBD, in adults.* And Humira is used to treat this condition in children ages 6 years and older if it hasn’t improved with other treatments.

If you have IBD that isn’t controlled with your current treatment, ask your doctor about Stelara or Humira.

* Both drugs treat moderate to severe Crohn’s disease, but Humira is used only when other treatment options haven’t helped enough.

Can I use Stelara and Humira together?

Most likely not.

In general, biologic disease-modifying antirheumatic drugs (DMARDs), such as Stelara and Humira, shouldn’t be used together. Doing so increases the risk of serious side effects from these drugs.

Biologic DMARDs are newer, more targeted treatments that help reduce inflammation by suppressing specific parts of your immune system.

Even though biologic DMARDs aren’t prescribed together, sometimes doctors prescribe a biologic DMARD with a traditional DMARD. Methotrexate (Trexall, Rasuvo, RediTrex, Otrexup)is an example of a traditional DMARD. Traditional DMARDs are older, less targeted drugs used to reduce inflammation in your body.

Also, if your condition isn’t controlled with your current biologic DMARD, your doctor may switch your treatment to another biologic DMARD. But this depends on many factors, such as:

• your condition
• past treatments or other current medications
• any side effects you’ve experienced
• your overall health

Do Stelara and Humira work the same way?

Stelara and Humira both work by suppressing overactive parts of your immune system. This helps lower inflammation that causes tissue damage and the symptoms of your condition. But they don’t work in exactly the same way.

Here’s how these drugs compare:

• Stelara lowers inflammation by blocking interleukin-12 and interleukin-23. These are inflammatory substances that your immune system makes in response to antigens (foreign invaders in your body). If your immune system overproduces these substances, it causes too much inflammation that can damage healthy tissues. This damage brings about symptoms of your condition.
• Humira lowers inflammation by blocking tumor necrosis factor (TNF). TNF is another substance that your immune system makes that leads to inflammation. It signals other immune cells so they can help fight infections. If your immune system makes too much TNF, it can cause too much inflammation that damages healthy tissues. This damage causes symptoms of your condition.

What are the side effects of Stelara and Humira?

Like many drugs, Stelara and Humira may cause side effects. These side effects may vary depending on the condition each drug is being used to treat. Overall, most common side effects of both drugs are mild, and serious side effects are rare.

Note: For more information about possible side effects, see this article on Stelara side effects and the side effects section of this Humira article.

Mild side effects

Stelara and Humira may cause mild side effects in some people. The chart below lists examples of mild side effects that have been reported with these drugs.

* Injection site reactions was the most common side effect seen in studies of Humira.

This chart may not include all mild side effects of these drugs. For more information on mild side effects of the two drugs, see the Stelara medication guide and Humira medication guide.

Serious side effects

In addition to the mild side effects described above, serious side effects may occur in people using Stelara or Humira. See the chart below for a list of possible serious side effects.

* Humira has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “What are the warnings of Stelara and Humira?” section below.

If you’re concerned about serious side effects, talk with your doctor about your risk for side effects with either drug.

What are the dosage and forms of Stelara and Humira?

Stelara and Humira are both liquids you receive by subcutaneous injection (an injection under your skin). You can give yourself an injection at home, or a caregiver can do this for you.

Stelara and Humira liquids come in the following forms:

• single-dose, prefilled syringes that come with needles
• single-dose vials* that are used with a separate needle and syringe

Humira is also available in single-dose pens that come with needles.

Your doctor or pharmacist can teach you or a caregiver how to give injections at home. But if you’re uncomfortable with giving yourself shots, a healthcare provider can inject either drug in a medical setting.

If you’re prescribed Stelara to treat Crohn’s disease, you’ll receive your first dose as an hour-long intravenous infusion (infusion into a vein) in a medical setting. This is called a loading dose. Your next doses will all be subcutaneous injections.

The Stelara or Humira dose your doctor prescribes will depend on your condition, age, weight, and other factors. The following describes how often you’ll inject Stelara and Humira once you’re taking the drug regularly.

With Stelara:

• For plaque psoriasis or psoriatic arthritis, you’ll inject the drug once every 12 weeks.
• For Crohn’s disease or ulcerative colitis (UC), you’ll inject the drug once every 8 weeks.

If you’re using Humira for plaque psoriasis, psoriatic arthritis, Crohn’s disease, or ulcerative colitis, you’ll inject the drug once every other week.

Talk with your doctor if you have questions about dosing or self-injections with either drug.

* Humira single-dose vials are used only by healthcare providers in a medical setting.

How effective are Stelara and Humira?

You may wonder whether Stelara and Humira are effective at treating your autoimmune or inflammatory condition.

Both drugs are used to treat certain active forms of plaque psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis (UC) in adults. “Active” means you have inflammation (swelling and damage) and symptoms. (For more details on uses for each drug, see the “What are Stelara and Humira used for?” section above.) See the sections below for information on the drugs’ effectiveness for these conditions.

To find out the effectiveness of Stelara and Humira for treating conditions in children, talk with your child’s doctor. And to learn about the effectiveness of Humira for uses other than those listed below, see this in-depth article.

For plaque psoriasis

Researchers combined the results from many studies on the effect of different treatments for chronic (long-term) plaque psoriasis in adults. When they looked at these results, they found Stelara and Humira to be about equally effective.

For psoriatic arthritis

The American College of Rheumatology (ACR) recommends both Stelara and Humira for the treatment of active moderate to severe psoriatic arthritis.

If you haven’t been treated before, Humira may be the preferred option over Stelara based on the ACR’s latest recommendations. But what drug your doctor recommends will depend on many factors. (For more details, see the “Can I switch between Stelara and Humira?” section below.)

For inflammatory bowel disease

UC and Crohn’s disease are the most common inflammatory bowel diseases (IBDs).

American Gastroenterological Association treatment guidelines strongly recommend both Stelara and Humira for moderate to severe UC in adults. Which drug your doctor prescribes will depend on many factors. (For more details, see the “Can I switch between Stelara and Humira?” section below.)

American Journal of Gastroenterology treatment guidelines strongly recommend tumor necrosis factor (TNF) blockers, such as Humira, to treat moderate to severe Crohn’s disease. TNF blockers can help adults with Crohn’s reach and maintain remission when standard options haven’t worked well enough. (“Remission” means you have no inflammation or symptoms.)

These guidelines also state that Stelara may be a good treatment option for some adults with moderate to severe Crohn’s disease. Stelara may benefit those whose condition hasn’t improved with other drugs, including TNF blockers. And it may be a good option for those who haven’t used a TNF blocker for Crohn’s.

Note: If you’d like to read about how each drug performed in certain studies, see the prescribing information for Stelara and for Humira.

What are the warnings of Stelara and Humira?

Stelara and Humira may not be right for you if you have certain medical conditions or other factors that affect your health. Here, these are referred to as warnings. The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below.

Before you start using Stelara or Humira, be sure to talk with your doctor to see if these warnings apply to you.

Boxed warnings: Humira

This drug has boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Serious infections

Using Humira increases your risk for serious or fatal infections caused by viruses, bacteria, parasites, or fungi. Examples include new tuberculosis (TB) infections, flare-ups of latent (dormant) TB, and yeast infections.

These infections may spread throughout your body and lead to sepsis, which is life threatening. Most people who’ve developed these infections were taking immune-suppressing drugs.

Before starting Humira, your doctor will test you for TB. If you have TB, you’ll need to be treated for it before starting the drug. Tell your doctor if you live or travel in areas where certain infections, such as TB, are more common. Also, tell your doctor if you’re more prone to infections or get them often.

While using Humira, watch for infection symptoms such as fever or chills, cough, weight loss, and body aches. See your doctor right away if you have these or other new symptoms. They’ll recommend ways to manage any side effects and may stop your Humira treatment.

Cancers

Though rare, cancers have developed in adults and in children using tumor necrosis factor (TNF) blockers such as Humira. Some cancers have been fatal. Examples include:

• nonmelanoma skin cancer
• leukemia
• lymphoma

Before starting Humira, tell your doctor if you’ve had cancer. While using the drug, watch for changes in your skin, unusual bleeding or bruising, paleness, extreme tiredness, unexplained weight loss, or other unusual symptoms. Report these symptoms to your doctor right away as they could be signs of cancer.

Other warnings

In addition to boxed warnings for Humira above, Stelara and Humira have other warnings.

Before using Stelara or Humira, talk with your doctor if you have any of the following conditions or health factors.

• Warnings for Stelara:
  • if you have low levels of interleukin-12 and interleukin-23 due to your genetics
  • if you have new or changing psoriatic plaques or lesions
  • if you’ve had or currently get allergy shots
  • if you’ve had or currently get phototherapy for psoriasis
• Warnings for Humira:
  • if you’ve had hepatitis B
  • if you have diabetes, heart failure, or a nervous system disorder, such as multiple sclerosis (MS)
  • if you use the following drugs:
    • Orencia (abatacept)
    • Kineret (anakinra)
    • Rituxan (rituximab)
    • Imuran (azathioprine)
    • Purinethol (6-mercaptopurine)
    • Remicade (infliximab)
    • Enbrel (etanercept)
    • Cimzia (certolizumab pegol)
    • Simponi (golimumab)
• Warnings for both Stelara and Humira:
  • if you’ve had an allergic reaction to either drug or any of their ingredients
  • if you’ve had TB, have an infection, are prone to infections, get infections often, or frequent areas where certain infections are more common
  • if you’ve had cancer or are currently being treated for cancer
  • if you’ve recently received a vaccination, especially a live vaccine, such as FluMist (intranasal flu vaccine)
  • if you have a latex allergy or sensitivity
  • if you’re pregnant or planning to become pregnant
  • if you’re breastfeeding or planning to breastfeed

To learn more about warnings for these drugs, see the in-depth articles on Stelara and Humira.

Can I switch between Stelara and Humira?

The short answer: It’s possible.

Details: Stelara and Humira are both biologic disease-modifying antirheumatic drugs (DMARDs). Biologics are newer, targeted therapies derived from living sources. And DMARDs suppress certain parts of your immune system to help reduce inflammation (swelling and damage). This helps prevent damage to your healthy tissues and symptoms of your condition.

These drugs are both used to treat similar autoimmune or inflammatory conditions, such as psoriatic arthritis or ulcerative colitis (UC). So you may be able to switch between Stelara and Humira.

In some cases, your doctor may recommend the switch. For example:

• If you have psoriatic arthritis that’s not controlled with Stelara, your doctor may suggest switching to Humira. This switch is recommended by the American College of Rheumatology.
• According to American Gastroenterological Association treatment guidelines, Stelara and Humira are both first-choice treatments for moderate to severe ulcerative colitis. So if you need to switch because of side effects or costs, it may be possible.

However, choosing to switch between these drugs isn’t always a simple decision. Your doctor may or may not recommend it based on many factors, such as:

• your condition and other medical treatments
• your experience with past treatments
• your risk for serious side effects
• any side effects you’ve had
• your other medications
• recommendations from the latest treatment guidelines
• drug costs or availability

Also, if you aren’t comfortable giving yourself injections, Humira may not be the best choice for you. Usually, you give yourself Humira every other week. With Stelara, you need to give yourself injections every 8 weeks or 12 weeks, depending on your condition.

If your condition is in remission or controlled by your current treatment and you don’t have side effects, switching drugs could cause a flare-up. A flare-up means your condition is active again and causing symptoms.

Keep in mind that only you and your doctor can decide which treatment is the best fit for you. Talk with your doctor if you’re using Stelara or Humira and interested in switching drugs.

Reminder: You shouldn’t switch drugs or stop your current treatment unless your doctor recommends it.

What should I ask my doctor?

If you have psoriasis or an inflammatory bowel disease, Stelara and Humira may help treat your condition. They have some similar serious side effects and warnings.

A main difference between these drugs is how often you use them. Once you’re on a maintenance dose, you’ll receive Stelara once every 8 or 12 weeks. Humira’s maintenance dose is one injection every other week.

Also, Stelara and Humira aren’t in the same exact drug class. So one may be a better fit than the other based on your condition, overall health, past or current treatments, and medical history.

If you have questions about these drugs for your condition, talk with your doctor or pharmacist. Ask about any concerns you have. Here are a few examples to get you started.

• I take other medications. Do either Stelara or Humira interact with them?
• I have cardiomyopathy (heart muscle disease). Is Stelara or Humira a better option for my psoriatic arthritis?
• How long does it take each drug to start working? Will one drug improve my symptoms faster than the other?
• Would Stelara or Humira be a better fit for me based on my health and medical history?
• Are there any side effects that happen from using either drug long term?
• How long have Stelara and Humira been used for my condition?

If you have psoriasis, subscribe to our newsletter for the latest guidance on treatment options, dealing with flare-ups, and more.

Ask a pharmacist

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.