The Latest in Psoriasis Treatment

Reviewed by Debra Jaliman, MD on November 11, 2020

In the 1960s and '70s, new info about how the immune system -- your body's defense against germs -- plays a role in psoriasis led to several new treatments. Drugs like corticosteroids, cyclosporine, and methotrexate became mainstays for managing the disease. For the next few decades, though, advances in treatment slowed down.

Thanks to recent progress in research, that's ancient history. New biologic therapies work well to treat psoriasis, and other new treatments are close to FDA approval.

New Era of Psoriasis Treatment

Research in psoriasis doesn't always make headlines -- or win funding -- like discoveries in cancer or heart disease. And studies are hamstrung by the one-of-a-kind nature of your skin. Unlike many other diseases, experiments on mice or other animals aren't very helpful.

In recent years, research into other autoimmune diseases brought new insights about the immune system. It turns out that some of the problems in those conditions are active in psoriasis, as well.

The new info brought treatments that target specific areas of your immune system. Called biologics, these drugs launched a new era of psoriasis treatment.


Medications That Can HelpExplore drug treatments that help your psoriasis symptoms.59

ASHLEY CURTIS: Our main goal

with treating psoriasis is

to calm down the inflammation,

which leads to the disease.

Treatment strategies

for each patient

depends on each individual case.

It depends on the severity

of the disease.

Is there arthritis associated

with it?

Where is the psoriasis?

Is it on your scalp?

Is it your nails?

Is it on your body

in other areas?

So it really depends on a lot

of different factors.

For the skin portion

of psoriasis,

we tend to start off with milder


and then work our way up.

But it also depends

on the severity of the disease,

when I first see a patient.

So we generally will start off

with topical medicines,

ranging from cortisones

to vitamin D creams.

Another safe treatment

for psoriasis that I've found

to be very helpful

is phototherapy.

It uses a safe wavelength

of ultraviolet lights

that we know can calm down

inflammation in the skin.

So patients tend to do very well

combining things

like phototherapy

with topical medicines,

or even oral medications.

Ashley Curtis, MD<br>Dermatology Associates of Atlanta/delivery/14/80/14805d25-f833-4274-a20e-701ea922b5de/vd-1644-medications-2.1_,2500k,750k,4500k,1000k,400k,.mp412/5/2017 5:45:00 PM00pills/webmd/consumer_assets/site_images/article_thumbnails/video/psoriasis_medication_video/650x350_psoriasis_medication_video.jpg091e9c5e81503ad0


They're medicines made from substances found in living things. Doctors inject these lab-made proteins or antibodies into your skin or bloodstream. Once inside the body, the drug blocks part of your altered immune system that adds to psoriasis.

In general, biologics work on psoriasis because they:

  • Curb T cells (a form of white blood cell)
  • Block a substance called tumor necrosis factor-alpha (TNF-alpha), one of the main messenger chemicals in the immune system
  • Stop a family of your immune system's chemical messengers called interleukins
  • Bind to proteins that cause inflammation

The patches and plaques of psoriasis come after an interaction between your skin cells and white blood cells. Biologics interfere with TNF-alpha or T cells, or they target interleukins. This short-circuits that unhealthy link. This will ease your inflammation. You'll have less growth of thick, scaly skin, too.

Biologic medicines approved by the FDA to treat moderate to severe psoriasis include:

  • Adalimumab (Humira), a TNF-alpha-blocking antibody
  • Adalimumab-adbm (Cyltezo), a biosimilar to Humira
  • Brodalumab (Siliq), a human antibody against interleukins
  • Certolizumab pegol (Cimzia), a TNF-alpha blocker
  • Etanercept (Enbrel), a TNF-alpha blocker
  • Etanercept-szzs (Erelzi), a biosimilar like Enbrel
  • Guselkumab (Tremfya), an antibody against interleukins
  • Infliximab (Remicade), a TNF-alpha blocker
  • Ixekizumab (Taltz), an antibody that binds to inflammation-causing proteins/interleukins
  • Risankizumab-rzaa (SKYRIZI), an antibody against interleukins
  • Secukinumab (Cosentyx), a human antibody against interleukins
  • Ustekinumab (Stelara), a human antibody against interleukins


Biologics are good at treating psoriasis. In clinical trials, each of the drugs lowered psoriasis activity by at least 75% in many people.

There are some drawbacks, though. Biologics can be expensive. Though they're safe for most people, they could raise your chances of infection, cancer, and other complications. Your doctor will need to keep close tabs on you to make sure you stay healthy.

Apremilast (Otezla)

Apremilast is a drug you take by mouth that's approved to treat psoriatic arthritis and plaque psoriasis in adults. It curbs phosphodiesterase-4 (PDE-4), an enzyme that controls inflammation.

Side effects include diarrhea, nausea, and headache. Some people in studies who took the drug lost weight. If you use the medicine, it's recommended that you check your weight regularly and watch out for signs of depression.

WebMD Medical Reference



Callen, J.P., Journal of the American Academy of Dermatology, 2003; vol 49: pp 351-356.

FDA: "FDA approves new psoriasis drug Taltz."

FDA: "FDA approves Amjevita, a biosimilar to Humira." 

Lebwohl, M., Journal of the American Academy of Dermatology, 2003; vol 49: pp S118-S124.

Lowes, M.A., Nature, 2007; vol 445: pp 866-873.

Nickoloff, B.J., Journal of Clinical Investigation, 2004; vol 113: pp 1664-1675.

Saini, R., Current Pharmaceutical Design, 2005; vol 11: pp 273-280.

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