ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Biologics for Psoriasis

Updated on February 6, 2017

What are BIOLOGICS?

Before we dive right into discuss the available biologics (aka "biologic response modifiers) for psoriasis, we first need to quickly define a "biologic drug."

Biologic drugs are somewhat difficult to define. Biologics differ from ordinary chemical prescription drugs. They are more complex molecules which require a far more involved manufacturing process to prepare. They include things like antibodies used to treat certain types of cancers, vaccines used to prevent diseases, interleukins used to treat a variety of conditions from rheumatoid arthritis to ulcerative colitis and TNF (tumor necrosis factor) inhibitors.

Biologic drugs have a high degree of specificity with respect to their target and mode of activity. For example, in the treatment of plaque psoriasis, biologic drugs have been designed to target T lymphocytes, interleukin (IL) -12 and IL-23 and TNF-alpha (tumor necrosis factor).

Biologics are very expensive and highly sensitive drugs which most often are delivered by injection, sometimes by the patient or sometimes by the practitioner.


What is PSORIASIS?

Psoriasis is currently understood to be an autoimmune disorder. The body mistakenly thinks our skin cells are "enemies" (to put it in simple terms) resulting in signals that speed up the process of skin growth. The condition often results in areas of reddened or flaky patches of skin - most commonly on the elbows, knees or trunk of the body. However, psoriasis can be more than a skin condition, often effecting the joints and resulting in arthritis-like symptoms. Anyone can develop psoriasis, though it most commonly arises between the ages of 15-35 and tends to run in families.

There are several distinguishable "types" of psoriasis, each with certain particular manifestations:

  • Plaque Psoriasis (the most common form)
  • Guttate Psoriasis
  • Flexural Psoriasis
  • Erythroderma
  • Generalized Pustular Psoriasis
  • Palmoplantar Pustulosis
  • Psoriatic Nail Disease

Approximately 7.5 million individuals in the U.S. have some form of psoriasis, 80% of which have plaque psoriasis.

Certain factors have been found to trigger cases of psoriasis such as trauma, stress, infections or alcohol. Many times psoriasis will develop without a specific trigger. The impact of psoriasis goes beyond the mere physcial effects it produces and also contributes, for many patients, to a decreased quality of life.

Treating psoriasis often begins with topical therapies such as corticosteroids, coal tar or moisturizing therapy. More severe cases will require treatments like phototherapy or oral medications such as methotrexate or immune suppressants like cyclosporine. Cases resistant these treatments may be advanced to consider biologic therapy for psoriasis.


STELARA (ustekinumab) 45mg/0.5mL, 90mg/mL injection from Centocor Ortho Biotech
STELARA (ustekinumab) 45mg/0.5mL, 90mg/mL injection from Centocor Ortho Biotech | Source

BIOLOGICS for Psoriasis

Biologics are used to treat Plaque Psoriasis which has been resistant to other forms of treatment, or when other treatments cannot be tolerated or are inappropriate. There are currently several biologic drugs on the market which have been approved by the FDA to treat psoriasis. Biologic drugs all carry some significant potential side effects. They differ in their precise dosages and how often they must be administered. Depending on your insurance, they may require you to try a particular biologic for psoriasis first, before you can try a different one. Most biologic drugs will require your doctor to get special authorization (called "Prior Approval") before he/she can order it. Often the drug will be delivered to you directly from a special pharmacy through the mail.

The following are the biologic drugs1 which are currently approved for the treatment of psoriasis:

Enbrel (etanercept): Available as 25mg and 50mg dosages in prefilled syringes for subcutaneous injection once or twice weekly.

  • For information on the use of Enbrel for psoriasis click HERE

Humira (adalimumab): Available as a 20mg/0.4ml and 40mg/0.8ml prefilled glass syringe for subcutaneous injection typically administered every other week.

  • For information on the use of Humira for psoriasis click HERE

Remicade (infliximab): Available as a 100mg single-dose-vial and given exclusively as an IV injection by a doctor. The initial dose is usually given, followed by a dose at 2 wees, 6 weeks and then every 6-8 weeks thereafter.

  • For information on the use of Remicade for psoriasis visit their website HERE

Stelara (Ustekinumab): Available in 45mg/0.5ml and 90mg/1ml vials and prefilled syringes given by an MD. The dosage is usually administered initially, followed by a dose at 4 weeks and then every 12 weeks thereafter.

  • For information on the use of Stelara for psoriasis click HERE

Simponi (Golimumab): Available as a 50mg/0.5ml prefilled syringe is generally given once per month. Although not approved for "plaque psoriasis" it is approved for an often associated condition known as "psoriatic arthritis."


General considerations about the above Biologics for Psoriasis:

  • These agents are generally approved only for patients over 18 years of age
  • These agents are generally approved only for patients with significant (>10%) body surface area (BSA) involvement, or involvement of sensitive areas like the face or hands.
  • Because of their effect upon the immune system, risks for serious infection exist. Patients will be monitored for signs of infection. Patients should be aware of the signs of infections like fever, chills, shortness of breath or other flu-like symptoms. Open cuts or wounds pose a risk of infection also. You may be tested for TB infection prior to using one of these biologics for psoriasis.
  • Other, more rare, but serious side effects possible with one or more of these biologic drugs include: lowering of your blood count, heart failure, or certain types of cancers.


1. I have not included information about the drug Amevive (alefacept) for the treatment of psoriasis as the manufacturer has decided to stop production of this product.

FAQ - Frequently Asked Questions

But do the Biologics actually work for the treatment of plaque psoriasis?

Numerous studies and patient experience confirm the fact that Biologics do in fact work very well for the treatment of psoriasis. Although the side effects can be serious, the potential benefits and improvement in both symptoms and quality of life are quite impressive.

How fast will they work?

Patient response will vary. Many patients will see improvement within 3-4 months. Results such as a 75% clearing of the skin is not uncommon.

How much do Biologics cost?

Biologic drugs are expensive, costing up to several thousand dollars a month for treatment. Most insurances today will cover biologic drugs for approved patients. Also, the manufacturers of these products also have patient-assistant programs available for those who do not have the resources to afford them.

Do the injections hurt?

Some burning or stinging at the injection site may occur. Allowing the injection to reach room temperature before injection sometimes helps.


Have a Question or Comment to share?

If you have any questions about these medications, feel free to ask below. If you have a personal experience with Enbrel, Humira, Remicade or Stelara that you want to share, feel free to do so also. Thank you for readying and I hope the information about biologics for psoriasis has been helpful.

Comments

    0 of 8192 characters used
    Post Comment

    • pharmacist profile imageAUTHOR

      Jason Poquette 

      6 years ago from Whitinsville, MA

      teaches12345,

      Thanks for the compliment! Hidradenitis is more like a type of acne, caused by blocked pores or glands. Psoriasis is more like an immune disorder. Both can cause skin problems and be challenging for patients for sure. Thanks again!

    • teaches12345 profile image

      Dianna Mendez 

      6 years ago

      This is great information for those who suffer from this disorder. Your explanations are easy for the common layman, as myself, to understand. Interesting read. Is this similar to hidradenitis?

    • pharmacist profile imageAUTHOR

      Jason Poquette 

      6 years ago from Whitinsville, MA

      L.L. Woodard,

      You are right. The biologics are a big leap and we are seeing more focus on them, especially in cancer research and other rare diseases. Thank you kindly for reading and sharing.

    • pharmacist profile imageAUTHOR

      Jason Poquette 

      6 years ago from Whitinsville, MA

      moonlake,

      Thank you for reading and sharing. There is definitely a strong genetic element to it, and thus we see it run in families. I'm glad to hear that whatever he is using is working. This can be a challenging condition for many. Best wishes!

    • L.L. Woodard profile image

      L.L. Woodard 

      6 years ago from Oklahoma City

      I think it's a big step in medicine that there are now fairly successful treatments available for people who live with psoriasis.

      Thanks for sharing this information.

      Voted up and SHARED.

    • moonlake profile image

      moonlake 

      6 years ago from America

      My husband has psoriasis. I can't tell you the name of his meds because I don't have them in front of me right now. His is working pretty good. Finally, he has suffered with this for a long time. I find it hard to believe is a autoimmune disorder. My husband has it,his brothers, one sister, his mother and our daughter.

      Interesting hub. Will bookmark it and show it to him.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)