Biologic Treatments for Psoriasis

If other psoriasis treatments don’t work the way you want, your doctor may suggest a drug that fights the causes, rather than just eases the symptoms. These drugs are called biologics. They target a specific part of your immune system.

The drugs block certain cells or proteins that play a role in psoriasis. They keep them from working like they should. While that helps with inflammation and other issues, it also lowers your body’s defenses.

A weaker immune system could make you more vulnerable to infections or diseases. It could also make a condition your body has under control, such as tuberculosis (TB), flare up again. While taking the drugs, it’s important to watch for signs of an infection such as fever, chills, and feeling tired or achy. You need to call your doctor if you have any of those signs.

You get some biologics as shots. With most of those, your doctor or nurse will show you how to do it, then you’ll give them to yourself at home. Others are given intravenously (IV). That means the medicine drips into a tube and goes through a needle into a vein in your arm. That’s done in your doctor’s office.

Researchers are always testing new biologics, and new ones may be approved down the road.

Biologics for Plaque Psoriasis

Brodalumab (Siliq). This medicine comes in a prefilled syringe, and you get one shot a week for 3 weeks. Then you take one every other week after that. Some people who take it may have a greater risk of thoughts and actions of suicide. So the FDA recommends that doctors weigh the risks and benefits of the medicine before suggesting it for people who have had depression or suicidal thoughts in the past.

Guselkumab (Tremfya). This drug also comes in a prefilled syringe. After your first shot, you’ll get another 4 weeks later then one every 8 weeks. Side effects can include:

  • Headaches
  • Diarrhea or other stomach issues
  • Pain or swelling in your joints
  • Upper respiratory infections

Ixekizumab (Taltz). This is a shot you get every 2 weeks for 12 weeks then once every 4 weeks after that. Some of the most common side effects are:

  • Upper respiratory infections
  • Nausea
  • Fungal infections

Your doctor will check you for TB before prescribing guselkumab or ixekizumab and watch you for signs of the disease while you use it.

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Biologics for Plaque Psoriasis and Psoriatic Arthritis

Adalimumab (Humira). With this, you give yourself a shot every other week. Side effects include serious infections (like tuberculosis) and higher chances of certain types of cancer (like lymphoma) and autoimmune disorders, such as a lupus-like syndrome. People who have heart failure or multiple sclerosis shouldn't take it.

Etanercept (Enbrel). This is another shot you give yourself -- twice a week for 3 months. After that, it’s one shot a week. Side effects include skin irritation and rashes. You shouldn't take it if you have multiple sclerosis, a weak immune system, hepatitis B, or heart failure.

Infliximab (Remicade). You get this through an IV, and each session lasts 2 to 3 hours. You'll follow up 2 weeks and 6 weeks after the first dose. Then you'll have treatments every 8 weeks.

Secukinumab ( Cosentyx). This comes in a prefilled syringe or a pen. You give yourself one dose a week for 5 weeks, then once a month after that. The most common side effects are:

  • Symptoms of a cold
  • Upper respiratory infection
  • Diarrhea

Your doctor will check to make sure you don't have TB before you start treatment and will watch you closely for signs of the disease while you’re on it.

Ustekinumab (Stelara). After the first shot, you get another 4 weeks later. Then you get one every 12 weeks. It makes your psoriasis patches thinner and eases scaling and redness. But it also can make you more likely to have certain kinds of cancer or a rare condition called reversible posterior leukoencephalopathy, a serious illness that affects your brain.

WebMD Medical Reference Reviewed by Debra Jaliman, MD on December 06, 2017

Sources

SOURCES:

Abel, E. "Psoriasis," ACP Medicine, BC Decker, 2005.

American Academy of Dermatology.

Amgen Prescribing Information, Amjevita.

Bruce E. Strober, MD, PhD, associate professor, vice chairman, director of clinical trials, department of dermatology, University of Connecticut; consultant to Amgen, Biogen, Genentech, Fujisawa, NexGenix Pharmaceuticals Holdings Inc. and 3M.

FDA: "FDA approves new psoriasis drug Taltz," “FDA approves Amjevita, a biosimilar to Humira,” "Cosentyx Medication Guide," "FDA approves new psoriasis drug," "Taltz Medication Guide."

Jeffrey M. Weinberg, MD, Mount Sinai St. Luke's, New York; associate clinical professor of dermatology, Columbia University College of Physicians and Surgeons; consultant to Amgen and Genentech.

National Institute of Arthritis and Musculoskeletal and Skin Diseases.

National Psoriasis Foundation.

PubMed Health: “Certolizumab (Injection),” “Golimumab (Injection).”

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