We are very excited to report Health Canada’s recent approval of a long-awaited vaccine for RSV (respiratory syncytial virus) for those aged 60 and older. It will be marketed under the name Arexvy and is produced by GSK.

RSV is a common contagious virus that affects the lungs and respiratory airways. Although all ages can be affected by the virus causing cold-like symptoms, those over age 60 years of age have increased risk which can lead to complications such as pneumonia, hospitalization, and even death. The risk is even greater in people with underlying medical conditions such as diabetes, chronic heart disease, and lung disease. RSV caused an estimated 470,000 hospitalizations and 33,000 deaths in those aged 60 years and above in high-income countries in 2019. The vaccine was 82.6% effective for the prevention of lower respiratory tract disease caused by RSV in older adults, and 94.6% efficacy in those with underlying medical conditions.

The vaccine is expected to be available before the RSV season, which typically starts in October. It is given as a single dose and the need for booster doses is not yet known. This non-live vaccine has been studied in combination with the flu vaccine and may be given at the same time. It is not yet publicly funded in Ontario but may be covered as a benefit on some private health plans. The cost of the vaccine has not yet been announced. Adverse events included injection site pain, fatigue, myalgia, and headache. These were typically mild to moderate and transient.

More information, including the product monograph, can be found here and should be consulted for complete administration and safety information.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

At least 387 different medications can cause phototoxic or photoallergic reactions.  As we hit the peak of summer weather,  it is important to take precautions when seeing an auxiliary label on your prescription warning of sun exposure.  These colourful warning labels put on your prescription are important.  The sun warning label is usually bright yellow with an image of a sun.  Anti-inflammatory medications fall in this group, such as naproxen seems to have the greatest impact. Other medications used by many of our blog followers that can increase sun sensitivity include sulfasalazine and hydroxychloroquine.  Methotrexate can cause a reaction known as radiation recall,  causing irritation in areas where you have had a past sunburn.

Protecting yourself from the sun calls to mind the famous phrase: SLIP, SLAP, and SLOP.  Slip on a long sleeve shirt and pants that are photoprotective, slap on a wide-brimmed hat, and slop on sunscreen with an SPF 30 or greater.  Sunscreen should be applied at least 15-30 minutes before going out in the sun and needs to be reapplied throughout the day, especially after swimming or excessive sweating.  We advise looking for sunscreens that have been endorsed by the Canadian Dermatology Association, which will be evident on the label. Of course, seeking out shade is key, especially during the peak sun hours of 11AM – 4PM.

If a sun sensitivity reaction happens,  seek medical attention as prescription medication may be needed to combat the reaction.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

As a pharmacy specializing in the treatment of autoimmune diseases, we are privileged to speak to many patients who have found life-changing benefits from the use of advanced therapies.  Hidradenitis Suppurativa is one such condition where biologic therapies such as Adalimumab (originator drug Humira) have had a significant impact.  The sad thing is that many people with this condition are not diagnosed until they have had symptoms for over 8 years.  Early treatment is important. 

This chronic inflammatory skin disease causes lesions to develop in areas of the body that contain a high density of apocrine sweat glands. Common areas where HS develops include the armpits, underneath the breasts, inner thighs, groin, and buttocks.  The lesions can be misdiagnosed as boils.  The condition usually starts at puberty when hormonal level change and apocrine sweat glands develop.  The tissue is painful and left untreated can lead to scaring and many negative health impacts.  According to the HS Foundation,  the exact cause of HS is not currently known. Still, research so far suggests that a combination of factors of genes, defects in the structure of hair follicles and sweat glands, immune system activation, and hormones may all play a role in the development of HS.

We also recommend you have a look at the HS Foundations Guidebook for patients living with HS as it is an excellent resource that was last updated in 2022.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Charlton Health is inspired by our patients living with lupus and we are privileged to provide advanced therapies that control this condition. We are pleased to share information about the WALK for Lupus.

WALK for Lupus Ontario registration is open and now finally in-person! Join thousands of participants through various WALKS across Ontario. 

The next 5 WALKS take place in:

• Richmond Hill – June 24 
• Barrie – July 7
• Hamilton/Halton – July 8
• Toronto – July 15
• Windsor – July 29

To participate in one of your local walks, visit WALK for Lupus Ontario. Registration/donation information can be found here.

The WALK for Lupus is Lupus Ontario’s largest provincial fundraising and awareness event. Over the years, the WALK for Lupus has raised over $1 million to fund the Lupus Ontario Geoff Carr Research Fellowship, support and education programs for lupus patients and their families, and advocacy projects aimed at improving programs and services for lupus patients. Lupus is a complex autoimmune disease that can impact virtually any bodily organ – skin, kidneys, brain, heart, eyes, and others – with profound life-altering and life-limiting consequences.

5 million people globally have some form of lupus, yet little is known about the disease as each patient presents with a differing array of symptoms. Hence, there is a consistently high demand for funding directed towards pioneering research, proactive advocacy, and inventive approaches that can enhance the health outcomes of individuals impacted by lupus.

Maher Jibrini is a Student Pharmacist from the University of Waterloo currently doing a rotation at Charlton Health as part of his final year of studies. Maher holds a strong passion for interprofessional collaboration at all levels of healthcare and looks forward to applying his knowledge across various professions in the healthcare & pharmaceutical industry.

The ‘nocebo effect’ is an interesting concept where negative expectations and beliefs about treatment or medicine can actually have a negative impact. This is opposite to the placebo effect, where positive expectations can result in positive outcomes. It shows how our thoughts and beliefs can affect how we feel, physically and emotionally. It’s important to be aware of our negative expectations and try to focus on positive thoughts to support our well-being. It is important to keep in mind that there are many factors that influence treatment success and this is only one of them. 

One such example of the nocebo effect was seen when studying patients who were switched from an originator molecule, such as Humira, to a biosimilar, as previously discussed on our blog. Patients who had not received the education needed to understand the effectiveness and safety of the biosimilar and alleviate any negative perceptions about the switch experienced adverse effects not seen in the group that had been fully educated. Sometimes misinformation regarding a treatment from various sources (e.g. social media), can lead to negative opinions about the treatment.

When starting a new medication or treatment, it’s important to remain aware of the nocebo effect and seek reliable sources for your information. 

To combat a potential nocebo effect, you can:

1. Stay positive
   • Maintain a positive mindset and focus on the potential benefits of your treatment. Believe in your ability to heal and stay hopeful.
2. Communicate openly
3. Talk to your healthcare provider about any concerns or fears you may have. Ask questions and seek clarification about the treatment plan, potential side effects, and realistic expectations.
4. Trust your healthcare provider
5. Build a strong relationship with your healthcare provider. Believe in their expertise and guidance.
6. Seek reliable information
7. Be cautious of unreliable sources of information that may exaggerate the negative aspects of treatment. Consult reputable sources and ask your healthcare provider for reliable information to understand your treatment better.
8. Stay engaged in your treatment

Maher Jibrini is a Student Pharmacist from the University of Waterloo currently doing a rotation at Charlton Health as part of his final year of studies. Maher holds a strong passion for interprofessional collaboration at all levels of healthcare and looks forward to applying his knowledge across various professions in the healthcare & pharmaceutical industry.

Charlton Health is pleased to launch a video explaining biosimilars.  We have received many questions about switching from an originator biologic to a biosimilar and this video will help support these questions.

We would love your feedback on this video and the tool we shared on our last blog.  Charlton Health takes great pride in providing educational resources to support patients and we appreciate our readers’ ongoing support of the content we provide.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

We are very excited to announce that the Canadian Spondylitis Association has added a great tool for patients to their website. This tool was developed by our own clinical pharmacist, Carolyn Whiskin.  The tool was designed to assist patients with rheumatic autoimmune diseases and better understand the risks of being in a state of active disease vs. receiving advanced therapies that can result in low disease activity or remission. It is important to understand that all treatments approved by Health Canada must demonstrate that the health benefits outweigh any risks. Even with that knowledge, patients need confidence that a treatment makes sense for them, and this tool will help in that process. 

Click here to use the Arthritis Treatment Risks tool.

We would love to hear your feedback and hope this is a beneficial resource for you.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Many of the advanced therapies for autoimmune diseases are protein-based medications we refer to as biologics. To avoid stomach digestion, which would render at this medication ineffective, they are given by subcutaneous injection (just under the skin) or infusion. Many of the injections are available as an autoinjector or a prefilled syringe. The syringe requires a person to push the needle through the skin and depress the plunger themselves. Some of these medications require two separate injections for one dose. 

Risankizumab (Skyrizi) is a biologic treatment for moderate to severe plaque psoriasis and psoriatic arthritis. It was initially available as a 75 mg prefilled syringe and each dose required two syringes to be given. Recently, a new formulation was developed whereby the full dose of 150 mg is now contained in one prefilled syringe or an autoinjector. For patients who may not have the dexterity to use the prefilled syringe or simply may not feel comfortable using it, the autoinjector now provides an amazing alternative to enable them to successfully self-inject their medication. For both these conditions, Skyrizi is administered at week 0, week 4, and then every 12 weeks as a maintenance dose. This is a great example of how manufacturers continue to enhance these medications to make them easier for patients to administer.  

Risankizumab has also been recently approved for Crohn’s disease, but in a different format than the dosing used for psoriasis and psoriatic arthritis. When treating Crohn’s Disease, the initial doses are given by infusion in a clinic. Maintenance doses are higher than that used for psoriasis or psoriatic arthritis (600mg) requiring a different type of automated device referred to as an on-body injection. This dispenses the medication through a subcutaneous needle over five minutes while the device has adhered to the skin.

As pharmacists at Charlton Health, it is exciting for us to see this innovation and the ability to grow our resources to support patient care.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

March is the month we celebrate the pharmacy profession, and the role pharmacists play in patient care.  As pharmacists at Charlton Health, working with our patients and health professional colleagues across Ontario is a privilege.  We appreciate the trust you place in us as a member of your healthcare team.  We take great pride in the information we provide on a daily basis helping patients navigate and understand their specialty treatments.

Pharmacy teams have been an immense force supporting Canadians through the many challenges we’ve faced. From caring for our communities through the pandemic, helping patients navigate care amidst the current healthcare crisis, managing ongoing drug shortages, and everything in between, the contributions of Canada’s pharmacy professionals have been remarkable!

Over the past few years, pharmacy professionals have grown their roles as immunizers, prescribers, and the first point of contact to the healthcare system for patients across the country. With a healthcare system under strain, pharmacy teams are more essential than ever.

This March, join us in celebrating Pharmacy Appreciation Month!

Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.