Psoriasis Treatment: Biologics

Biologics are an innovative treatment for inflammatory diseases as they slow or stop damaging inflammation on a molecular level in our bodies. By injecting these lab-made proteins or antibodies into you subcutaneously (under the skin) or intravenously (into the veins), biologic medications inhibit much of the molecular activities that play a role in how the immune system causes an inflammation. As psoriasis is the result of skin inflammation, biologics work on psoriasis because they either interfere with tumor necrosis factors-alpha (TNF-alpha) or T-cells (a type of WBC), or they target interleukins (a family of chemical messengers of the immune system) to specifically hinder, and potentially stop, skin inflammation. The molecules biologics target are known as cytokines as they are molecules that play a role on immune cells and assist in immune signaling.

In clinical trials that have used multiple biologic medicines on psoriasis patients, each drug showed a decreased psoriasis activity of at least 75% in many patients. Though effective, biologics also come with drawbacks. They can be expensive, and though safe for most people, it may raise the chances of infection, cancer, and other complications for some.

Other recent advances in psoriasis treatment are Tapinarof (Vtama) and Apremilast (Otezla). Tapinarof is a steroid-free cream that acts as an aryl hydrocarbon regulator agonist, stimulates a receptor which regulates the development and function of immune cells. It is approved for mild, moderate, and severe plaque psoriasis in adults and can be applied once a day in sensitive areas. It has been proven to be effective and safe for long-term use. Apremilast is a drug administered orally and is approved to treat psoriatic arthritis and plaque psoriasis in adults. It works by curbing phosphodiesterase-4 (PDE-4), an enzyme controlling inflammation. It does, however, cause side effects including diarrhea, nausea, and headaches. Some tests have shown signs of patient weight loss, so it is recommended to those who take this drug to check their weight regularly and for signs of depression.