Biologics and biological therapies for treating psoriasis


Biologic mediations are specifically designed to mimic chemicals that are naturally found within the human body. Biologics are also known as biological therapies which are drugs made from living material such as human or animal proteins. These living cells are cultured in a laboratory. Biologic drugs target specific parts of the immune system unlike systemic drugs which are administered into the circulatory system so that the entire body is affected.

Biologics are not new and have actually been in use for over a 100 years. It is only recently however that biologics have been used in the treatment of psoriasis and psoriatic arthritis.

Biologics are different from traditional systemic drugs that impact the immune system. Biologics instead target specific parts of the immune system. The biologics used to treat psoriatic disease block the action of a specific type of immune cell called a T cell, or block proteins in the immune system. In psoriasis certain T cells are activated and move into the skin. Once in the skin they can begin to act as if they are fighting an infection or healing a wound which can lead to the rapid growth of skin cells, and the development of psoriasis. This rapid growth causes cells to pile up at the skin surface. Certain biologic drugs prevent the activation of T Cells by reducing the number of T cells in the body.

Types of biologics

NICE have issued guidelines on when biologic drugs can be prescribed for four biologics used to treat psoriasis:

Etanercept
Infliximab
Adalimumab
Ustekinumab

NICE recommends that Etanercept, Adalimumab and Ustekinumab are prescribed for people with severe psoriasis who have higher scores on the PASI (Psoriasis Area and Severity Index) and DLQI (Dermatology Life Quality Index).

How biologics are administered

Biologics are administered at defined intervals either by injection or intravenous infusion at a hospital or clinic over a set period of time.

When would biologics be used?

Biologics are used in patients with moderate to severe psoriasis where:

  • All other treatments have failed
  • Side effects of other treatments become intolerable
  • Concurrent diseases preclude the use of currently available systemic therapies

Side effects

Psoriasis and psoriatic arthritis patients should talk with their doctor or other healthcare professional about the short/long-term side effects and risks of being treated with biologic medication. Biologics are generally safe and well tolerated. However, like all medicines, they may cause adverse effects. Importantly, these medications can predispose patients to infections. Common side effects for biologics include:

  • Respiratory infections
  • Flu-like symptoms
  • Injection-site reactions

These side effects are generally mild and in most cases do not cause individuals to stop taking the medication. However, you are advised not to take biologics if:

  • Your immune system is significantly compromised;
  • You have an active infection.

The development of biologic therapies has revolutionised psoriasis treatment. With time, long-term side effects and effectiveness will become clearer and help determine which biologics are the most suitable for the long-term care of psoriasis.

You may also be interested in the following information:

Psoriasis – A Patient Journey – further information about psoriasis

Emollients and moisturisers for use in the treatment of psoriasis

Sources used in writing this article are available on request

Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence based articles are accredited by the PIF TICK, the only UK quality mark for trustworthy health information. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

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Information written by the talkhealth team

Last revised: 9 January 2018
Next review: 9 January 2021