The biologic agents approved by the FDA for treatment of moderate to severe psoriasis include:
- Adalimumab (Humira), a TNF-alpha blocking antibody
- Etanercept (Enbrel), a TNF-alpha blocker
- Infliximab (Remicade), a TNF-alpha blocker
- Secukinumab (Cosentyx), a human antibody against interleukins
- Ustekinumab (Stelara), a human antibody against interleukins
Biologic agents work well for treating psoriasis: in clinical trials, each of the drugs reduced psoriasis activity by at least 75% in many people. However, these new medications have drawbacks. Biologic agents for psoriasis treatment can cost hundreds or thousands of dollars per month. Although safe for most people, close monitoring is needed for an increased risk of infection, cancer, and other complications.
Apremilast is an oral drug approved to treat psoriatic arthritis and plaque psoriasis in adults. It's an inhibitor of phosphodieasterase-4 (PDE-4), an enzyme that controls inflammation within a cell. Side effects include diarrhea, nausea, and headache. These side effects may stop with continued treatment. In studies, a small number of people stopped taking Apremilast because of an adverse reaction. Some participants also had unexplained weight loss. It's recommended that those taking the drug have their weight monitored regularly and also be monitored for depression.