Managing Psoriasis with Biologic Medications

Written by Malini Fowler, MD, Board Certified Dermatologist on May 29, 2020 No Comments

biologic treatments for psoriasis

Psoriasis is a chronic and often painful skin condition where skin cells reproduce faster than normal resulting in reddish, round skin patches and silvery appearing scales. Psoriatic skin rapidly matures and piles up to form inflamed, raised, and red lesions along the skin. While psoriasis can manifest anywhere, the most common affected areas include the elbows, knees, or scalp. Psoriasis sufferers may experience burning, itching, and stinging sensations in areas of buildup.

While there is no cure for psoriasis, researchers determined that genetics, and in particular the genetic characteristics of one’s immune system, play a key role in its development. Additionally, there are some common “triggers” that cause psoriasis symptoms to occur and become more severe. Many effective treatment options aimed at managing psoriasis symptoms work to minimize symptom flare-ups by altering the immune system. One such application is biological drugs (or biologics), which is an effective way to address more severe forms of psoriasis.

What Are Biologics?

Biologic drugs, also known as biologic medication or biologics, are prescribed medications that are commonly used to address more severe forms of psoriasis. They target a specific portion of the immune system, which is responsible for both psoriasis and psoriatic arthritis development. Due to the more specific nature compared to other systemic medications, they are effective in treating psoriasis symptoms with limiting potential side effects.

There are 11 biologics focused on treating psoriasis currently on the market:

  • Remicade
  • Humira
  • Enbrel
  • Stelara
  • Taltz
  • Cosentyx
  • Tremfya
  • Siliq
  • Cimzia
  • Llumya
  • Skyrisi

How Do Biologics Treat Psoriasis?

Biologics are protein-based medications that are genetically engineered to mimic natural immune system substances. Biologics work by either blocking immune system cells (T-Cells) who’s actions result in psoriasis symptoms like inflammation and itchiness or by blocking specific proteins (cytokines) that are responsible for skin cell overgrowth. This results in fewer and less severe psoriasis symptom farel-ups.

How Are Biologics Administered?

Biologics are primarily administered through an injection, although they can be provided via intravenous (IV) infusion if needed.

How Often Is Treatment Necessary?

Depending on patient need and the type of biologic drug used, the frequency of biologic injection can vary from weekly to once every 12 weeks.

How Effective Are Biologics?

While biologics will not completely cure psoriasis, they are very effective in managing psoriasis symptoms. Most patients experience both less frequent and less severe flare-ups. Many patients realize noticeable improvement in symptoms after their first injection. However, it can take up to 6 weeks (and a few injection sessions) for the full effect of biologic treatments to fully manifest.

Are There Side Effects?

Common side effects of biologic drugs can include redness, irritation, or minor pain in the injection site. Diarrhea and headaches are also possible.

Biologics can also result in a suppressed immune system which can reduce the body’s ability to fight disease or infection. Patients are encouraged to discuss risks and side effects of biologics with their physician.

Am I A Good Candidate?

Generally, any individual in good overall health who is suffering from moderate to severe psoriasis is a great candidate for biologic treatments. Individuals who have previous immune system issues, who are pregnant or nursing, or who have an active infection should not take a biologic until cleared to do so by their physician. Biologics may not be safe for patients who have cancer, heart failure, liver disease, or multiple sclerosis.

Can Biologics Be Used Alongside Other Treatments?

Most biologics are safe for use with other popular psoriasis treatments like phototherapy or topical medications. Patients should discuss pairing biologics with other psoriasis treatments with their dermatologist.

Malini Fowler, MD

Dr. Malini Fowler is a Board Certified Dermatologist that completed her undergraduate studies and graduated summa cum laude from the University of St. Thomas in Houston, Texas. She is a fellow of the American Academy of Dermatology and member of the American Society for Dermatologic Surgery. Dr. Fowler enjoys providing medical, cosmetic and surgical dermatology at our new San Antonio office.

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