Biological Treatment for Psoriasis: An Overview

Psoriasis is characterized by the classic formation of a thickened skin with plaque and scaly appearance. It is considered to be an autoimmune disorder where the immune system causes a rapid proliferation of cellular formation in the skin. The condition commonly affects the scalp, elbows and knees. In its milder form, psoriasis may cause insignificant symptom of dry skin patches that makes the affected person unaware of having the condition. Severe cases of psoriasis may affect the whole body, covering it with red, thick, scaly skin.

Because psoriasis have no cure, the main form of treatment used in managing the disease is controlling the immune responses that trigger the occurrence of the symptoms. The course of the disease is variable. It may consist of periodic worsening and then may stay in remission. Doctors usually prescribe the treatment of using biological agents once the regular medications for managing the symptoms of psoriasis are ineffective. It is known to be a safe substitute for oral medications where psoriasis treatment is unresponsive.

What are biological agents?

Unlike the oral medications indicated for psoriasis that are made from chemicals or plants, biological agents are made up of proteins. They work mainly in targeting the body's immune response that causes the abnormal rapid skin cell formation in psoriasis. These drugs are introduced in the body intravenously or by injection. The proteins in the drugs are cultured from a medical laboratory. Biologic agents produce potent effects, mainly targeting only the specific cell, called the T cells, in the immune system that produces the psoriasis symptoms. The protein from the biological agents works to block the T cell to prevent it from triggering the abnormal occurrence of rapid skin cell activities. It also causes a barrier to the interleukins 12 and 23, and the tumor necrosis factor-alpha (TNF-alpha) proteins that also contribute to the pathological manifestations of psoriasis symptoms.

When do you need biological treatment for psoriasis?

Doctors usually consider biological agents in treating psoriasis only when the basic drugs prescribed as first line of treatment for the condition fail to produce the expected response from the patient.  Biological agents can be costly, especially when considering it as a lifetime maintenance form of treatment. It can also suppress the activity of the immune system that makes a person more susceptible to infection and other diseases. Your doctor will usually weigh the risks and benefits before prescribing biological treatment for your condition. Among the considerations that doctors will take include the extent of the severity of symptoms, the patient's health condition, the response of the patient to other forms of treatment and the patient's preferences.

Biologic agents are not indicated for patients with an already compromised immune system, such as in the presence of an active infection, because of the potential adverse effect it may produce to the body. Among the side effects of taking biologic agents include the development of flu-like symptoms and respiratory infections. The symptoms, however, are usually mild and manageable with other medications. Rarer side effects usually involve cancer and neurologic disorders like seizure, nerve inflammation in the eyes, and multiple sclerosis.

Commonly prescribed biological agents for psoriasis

There are varieties of FDA approved agents used for the biological treatment of psoriasis which include the following:

• Stelara
• Simponi
• Humira
• Enbrel
• Remicade

These agents are usually prescribed and taken with other forms of treatment for psoriasis like phototherapy and topical medications. However, using Remicade with phototherapy may cause cancer and doctors usually do not combine these two forms of treatment. In deciding whether biological treatment for psoriasis is right for you, it is important to discuss with your doctor your preferences including the risks and benefits of the treatment.