INFOGRAPHICPSORIASIS

Biologic Treatments for Psoriasis

October 16, 2023
Biologic Treatments for Psoriasis WHAT ARE BIOLOGICS, EXACTLY? ● Biologics are systemic medicines made of proteins. ● They’re usually given as injections into the skin, but a few are given as infusions into the veins. ● Simply put, they balance the inflammation in the body, easing skin and joint symptoms. There are at least a dozen biologic drugs on the market with FDA approval for psoriasis and psoriatic arthritis. Some of the names you may recognize are Cimzia (certolizumab), Cosentyx (secukinumab), Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab), Skyrizi (risankizumab), and Stelara (ustekinumab). WHO SHOULD TAKE BIOLOGICS? Biologics can be prescribed for: • Moderate-to-severe psoriasis • Psoriatic arthritis • When topicals and oral medications haven’t worked and/or shouldn’t be used ARE THERE ANY RISKS? Biologics are considered fairly safe for most people, but they do increase the risk of: • Common infections, such as colds and the flu • Serious infections, such as tuberculosis If you develop any sign of an infection, such as a fever, cough, or flu-like symptoms, you should contact your doctor immediately. You shouldn’t take biologics if you: ● Have an active infection ● Have active cancer ● Have recently received a live vaccine (such as MMR, shingles, rotavirus, or the nasal flu vaccine) Most Common Side Effects of Biologics ● Redness or pain at the site of injection ● New rash HOW TO TAKE THEM Injections are subcutaneous—just under the skin. Biologics may be injected at the doctor’s office or self-injected at home. Intravenous (IV) infusion can be done at home or at a doctor’s office but requires the medication to be given into the veins. There are two types of doses for biologics: • A loading dose gets the medication into the body at the right level. • Maintenance doses keep it at that level, so the medication can continue to be effective. The frequency depends on the medication. Maintenance doses for some biologics are every 2 weeks; others are given monthly or every 3 months. Using Biologics with Other Psoriasis Treatments Biologics can be used alongside other psoriasis treatments, like topicals, orals, or phototherapy. Your doctor will tell you which treatments are safe and effective to use in combination. For example, biologics may be added to oral methotrexate to improve symptoms of psoriatic arthritis. WHAT’S THE COST? One downside of biologics is the expense. Most of these drugs cost more than $20,000 per year—in some cases, more than $50,000—and not all health plans cover the expense. Here are some things you may be able to do to lower the cost to you: • Work with your doctor to find one that’s covered by your health insurance. • Get insurance pre-authorization from your doctor. • Take advantage of patient assistance programs and coupons from the manufacturer. • Compare prices at different pharmacies. • Look into non-profit and state-level financial assistance. • Consider changing health plans or getting supplemental insurance. DO THEY ACTUALLY WORK? Biologics can achieve incredible results and are widely considered to be more effective for treating psoriasis than traditional systemic medications. Some people may need to try several biologics to find the one that works well for them. WHAT ABOUT BIOSIMILARS? A biosimilar medicine is one that’s modelled after an FDA-approved biologic medicine. They are very similar to biologics and are considered just as safe and effective. Biosimilars have the same risks and side effects, too. There are a few biosimilars currently used to treat psoriasis and psoriatic arthritis: ● Amjevita and Cyltezo, which are biosimilar to Humira ● Erelzi, which is biosimilar to Enbrel ● Inflectra and Renflexis, which are biosimilar to Remicade Other biosimilars are currently being developed and tested. SOURCES American Academy of Dermatology, “Psoriasis Treatment: Biologics.” National Psoriasis Foundation, “Biologics.” Menter, A., et al. (2008) Guidelines of care for the management of psoriasis and psoriatic arthritis. Journal of the American Academy of Dermatology. Cheng, J, and Feldman, Steven R. (2014) The cost of biologics for psoriasis is increasing. Drugs in Context. Constantin, Maria M., et al. (2019) Biosimilars in dermatology: The wind of change. Experimental and Therapeutic Medicine.