Biologics for Psoriasis

Psoriasis Biologics are the most advanced, the most promising and the most researched psoriasis treatment nowadays.

Psoriasis Biologics are developed with the aid of the modern molecular biotechnologies.

Biologics may be obtained with 2 main ways:

1. isolated from live cells - human, mammal, or microorganism;
2. produced by biotechnologies.

Most often the biologics represent "custom-designed" monoclonal antibodies, similar to the antibodies used by the human immune system to fight off bacteria and viruses.

Some biologics are approved by the FDA for the treatment of moderate to severe psoriasis and the treatment of psoriatic arthritis.

Biologics for Psoriasis may be especially used if no other psoriasis treatments have worked.

Psoriasis Biologics Action

Mechanism of action of Psoriasis Biologics is directed toward inhibiting the immune system defects related to psoriasis.

Biologics target particularly the cells, which participate in the development of psoriasis and psoriatic arthritis.

The following can be achieved with Psoriasis Biologics:

• Inhibiting the activated T-cells.
• Inhibiting the migration of T-cells into the epidermis.
• Inhibiting the TNF (tumor necrosis factor) cytokines.
• Inhibiting the conversion of one cytokine into another.

Psoriasis Biologic Agents

• Amevive (alefacept) is approved by the FDA for chronic plaque psoriasis treatment. 

• Raptiva (efalizumab) is approved by the FDA for psoriasis treatment.

• Enbrel (etanercept) is approved by the FDA for psoriasis and psoriatic arthritis treatment.
  Action - TNF antagonist.

• Remicade (infliximab) - approved by the FDA for psoriasis and psoriatic arthritis treatment.
  Action - TNF antagonist.

• Humira (adalimumab) is approved by the FDA for psoriatic arthritis treatment.
  Action - TNF antagonist.

Some Psoriasis Biologics (etanercept, infliximab) specifically target Tumor Necrosis Factor (TNF), which plays one of the main roles in the pathogenesis of Psoriasis and Psoriatic Arthritis. Such Psoriasis Biologics act as the TNF antagonists.

The TNF cytokine regulates the inflammation. Therefore the regulation of the TNF cytokine functions is crucial for the treatment of Psoriasis and Psoriatic Arthritis.

Psoriasis Biologics Usage

Psoriasis Biologics are usually introduced once a week for at least 12 weeks either:

• as a shot under the skin (can be done at home);
• in an IV (intravenously);
• as a shot in a muscle.

Psoriasis Biologics Advantages

1. Biologics do not get included into the metabolic processes in the body, they are not excreted through the liver, kidneys or the Gastrointestinal Tract (GIT) and therefore they do not create side-effects, connected with the metabolism. Therefore Psoriasis Biologics compared to some other psoriasis treatments are less likely to cause kidney, liver, and GIT problems.
2. Psoriasis Biologics significantly reduce the symptoms of psoriasis, providing fast and prolonged improvement. Various trials indicate a 75% improvement in over 50% of the patients after a Psoriasis Biologics treatment and a 70% response rate to psoriatic arthritis biologics treatment. Continued treatment can lead to a prolonged psoriasis remission.

Psoriasis Biologics Disadvantages

1. Biologics for Psoriasis and especially their long-term treatment safety are not completely studied or yet known.
2. The cost of biologics is much higher than the conventional medications - currently the yearly cost of Psoriasis Biologics treatment may lie anywhere in the range of 10,000-20,000 USD (7,000-14,000 EUR). Psoriasis and psoriatic arthritis are chronic diseases; therefore the costly treatment will have to be conducted during the remainder of life. Though biologics may often be covered by insurance.
3. Biologics affect the body's ability to fight all infections; therefore they may often "help" in catching a cold or flu.
4. Biologics may sometimes cause an allergic reaction to the injection (shot) or an IV infusion (medicine given in a vein). The possible allergic reaction will usually happen either during the infusion or within a couple hours after the procedure. The allergic reaction may be prevented or stopped by special medicines given by your doctor.
5. Biologics cause an increased risk of blood disorders characterized by bruising or bleeding.
6. Biologics cause an increased risk of nervous system disorders characterized by numbness, weakness, tingling, vision problems etc. Such states should be also observed by a psycho-neurologist.
7. Biologics "mess" with the immune system, therefore they cause an increased risk of a serious infection (tuberculosis etc.), anemia, and possibly even cancer.
8. People with a weakened or impaired immune system, such as those infected with HIV, should not take biologics.

Biologics Now and Then

It's very exciting that biologics nowadays can hit specific immunological targets involved in specific disorders. The biologics from the past (insulin, interferon etc.), used to target and to suppress the immune system as a whole, thus creating various bad side-effects.

Theoretically, the smaller is the target of the biologic agent, the less is its harmful impact on the rest of the immune system and the less are its side-effects.

I really hope to see such improved tiny Psoriasis Biologics in the near future.

It is estimated, that in the future the Biologics for Psoriasis will target even smaller molecule fragments, thus becoming less deteriorating for the immune system, smaller in size, and cheaper.

Generic Psoriasis Biologics

Biologics have a higher molecular complexity than most drugs, and they are very sensitive to manufacturing process changes. Nearly undetectable differences in the drugs may cause serious health problems, due to that there are problems with the creation of the generic versions of biologics. Unlike most drugs, generic versions of biologics have to go through much more complicated procedures in order to become approved in the US or the European Union.

In the US the FDA said that there should be created some new legislation to address this issue, but so far there had been no new legislation approved (as of June 2008).

Questions to Ask Your Doctor:

1. Will the benefits from the Psoriasis Biologics outweigh my risks?
2. Will I be able to give myself a shot under the skin at home with this particular Psoriasis Biologics?
3. Which medications or vaccines should I avoid when using this particular Psoriasis Biologics?

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