Understanding the Use of Biologics for Psoriasis
Psoriasis is an autoimmune condition that causes the body to rapidly produce more skin cells than is necessary, leaving the sufferer with painful, itchy, raised and flaking red patches of skin. There is no cure for psoriasis but there are various types of treatments to consider. When treating psoriasis, many traditional drugs target the entire immune system to try to slow the rate of production of skin cells, whereas biologics for psoriasis is a type of treatment that will target certain parts of the immune system in isolation. Considering biologics work especially well in conditions that deal with inflammation, they are thought to be able to help in the treatment of psoriasis — in particular plaque psoriasis or psoriatic arthritis. But what exactly are they and how do they work?
What Are Biologics?
Through the use of medical biotechnology, biologics are created using a variety of products from humans, animals and microorganisms. They target specific parts of your immune system and change the way proteins and cells in your body respond. Depending on the type of biologic prescribed, they can be administered by injection into the leg, abdomen, or arm, or by IV infusion. There are some types of biologics that may be able to be self-administered or administered by a family member, but this is something to discuss with your healthcare provider.
According to the National Psoriasis Foundation, certain biologics can block certain types of immune cells, like T cells. T cells are types of white blood cells that are essential for the immune system. In psoriasis, it is the T cell, known as T-helper lymphocytes, that cause an overproduction of certain chemicals, which in turn triggers skin inflammation. T-cell inhibitors are a type of biologic that will target these specific T cells in the body and prevent them from activating.
How Biologics Can Treat Psoriasis
Biologics may also be used to block certain proteins that can trigger psoriasis development. Psoriasis can be caused by the overstimulation of the TNF-alpha protein (tumor necrosis factor-alpha), therefore the biologic known as the TNF-alpha inhibitor can work to stop the overproduction of this protein in the body. Two other types of proteins are also linked with psoriasis (IL-17 and IL-23), and both of these proteins have specific biologic inhibitors that can deactivate these proteins in the body.
Types of Biologics That May Help
There are many types of biologics for those suffering from psoriasis and psoriatic arthritis to try. As stated, some biologics will target different proteins or T cells, and not every biologic works for everyone. Other types of biologics for those who suffer from psoriasis:
It’s important to check if the biologic you are looking to use is able to be used with any other medications you are using. Some biologics can be used in conjunction with other medications you are using for psoriasis, such as topical ointments or phototherapy.
What Are the Side Effects?
There are several side effects a person may experience should they use biologics. Minor reactions may include an injection site reaction (should you have biologics injected). This may appear as redness or swelling, or the site may be itchy or painful. Similarly, if a biologic is administered via transfusion, then a side effect may be an infusion reaction, which can cause redness and swelling but may also cause other symptoms like nausea, fever or chills, or a rash.
The Weakening of the Immune System
Another side effect to be wary of is that there is an increased risk of infection. Biologics weaken your immune system in order to reduce psoriasis swelling, therefore you are more open to the risk of infections. On a less severe scale, you may be more at risk of catching a cold. On a more severe scale, you may be more at risk of tuberculosis (TB) and septicaemia.
The risk of infection due to taking biologics can be referred to as common infections and opportunistic infections. Common infections relate to conditions like upper respiratory infections and pneumonia, while opportunistic infections (which are less likely in healthy people taking biologics), include TB. There is also a risk of allergic reactions when someone is taking a biologic for the first time. Before you undertake any biologic treatment, be sure to discuss these side effects with your healthcare provider who will be able to help you monitor your wellbeing before, during and after treatment.
Unfortunately, there is no one-size-fits-all method. According to Arthritis Foundation, you may start off with a biologic that works well for you, but over time it may stop working. Also, not every biologic will work the same for everyone. Biologics are often something to consider if other types of drugs or treatment have already been tried to no avail. Make sure you discuss all the options you have already tried with your healthcare provider, as they will be able to point you in the right direction of a biologic that may work for you should this be the next step in your psoriasis treatment journey. While biologics may not be for everyone, it shows progress is being made in the creation and production of new psoriasis treatments.