If you suffer from psoriasis, you may be encouraged to know that we are in the midst of a revolution in the treatment of the condition – that is, biologic therapies. These medications are designed to target specific components of the immune system and are a major advancement over traditional immunosuppressive treatments like methotrexate and cyclosporine.
The decision to use these therapies depends on factors of your individual case, including the severity of the psoriasis, to what degree it affects your life, and your overall health.
What Are Biologics?
By definition, a biologic is a protein-based drug derived from living cells cultured in a laboratory. It may be a new term for many of us, but biologics have been used to treat diseases like diphtheria and polio for over a century.
The discovery of DNA opened new vistas for these treatments. New vaccines are being developed and modified as new discoveries teach us more about the human immune system.
Biologics vs. Psoriasis
Biologics are prescribed for people with moderate to severe cases of plaque psoriasis and psoriatic arthritis.
According to the National Psoriasis Foundation, one of the major advantages of biologic drugs is that they target individual areas of the immune system. When they are used to combat psoriasis, they block the action of a specific type of immune cell called a T cell, or they inhibit proteins in the immune system. These cells and proteins play a major role in developing psoriasis and psoriatic arthritis.
For example, certain biologics block TNF-alpha, a protein that prompts the body to create inflammation. In psoriasis and psoriatic arthritis, there is excess production of TNF-alpha in the skin or joints. That leads to the rapid growth of skin cells and damage to joint tissue. Blocking TNF-alpha production helps stop the inflammatory cycle of psoriatic disease.
How Are They Administered?
Biologics are taken by injection or by IV infusion. Many are injected in the legs, abdomen or arms -- typically by the person with psoriatic disease, him or herself, or a family member. The biologic called Stelara is administered as a subcutaneous injection by a health care provider. Another, named Remicade is given through IV infusion in a doctor’s office or infusion center.
Are There Risks?
As with any medical treatment, the answer is yes.
Screening for tuberculosis or other infectious diseases is required before starting treatment with several types of biologic drugs.
Biologics can also increase the risk of infection. If you develop any sign of an infection such as a fever, cough or flu-like symptoms or have any cuts or open sores, you should contact your doctor right away. Also, the impact of biologics on developing fetuses or nursing infants is not fully known.
The most common side effects for biologics are:
- Respiratory infections
- Flu-like symptoms
- Injection site reactions
These side effects are generally mild and in most cases don’t cause people to stop taking the medication.
There are also rarer, but more severe, side effects to consider, including:
- Serious nervous system disorders, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes
- Blood disorders
- Certain types of cancer
The advances in treatment for psoriasis that biologics bring have been dramatic. But in the end, each person, along with his or her medical professional, must weigh the risk/reward of biologic treatments to treat psoriasis.