Psoriasis is a common chronic immune disease that causes skin cells to grow quickly. The fast growth can lead to scaly, itchy, dry, and red skin patches. Around 7.4 million people in the United States have psoriasis.

There are several treatment options for psoriasis, including topical treatments, prescription drugs, and phototherapy. If you have moderate to severe psoriasis and your current treatment isn’t working, it may be time to think about a biologic.

Keep reading to find out more about this newer class of drugs.

Why are biologics a good option for psoriasis treatment?

Biologics are target-specific drugs that act by blocking certain inflammatory cytokines. Unlike other drugs that are derived from plants or chemicals, biologics are made from sugars, proteins, or nucleic acids. They may also be made from human, animal, or microorganism cells and tissues.

Biologics are considered to be both safe and effective.

How do biologics work?

Biologics used to treat psoriasis work by blocking certain inflammatory cytokines produced by specific pathways that cause psoriasis. Biologics target cytokines produced by two main pathways: Th1 and Th17.

Th1 mechanism

Some biologics target cytokines produced by T helper cells (T cells), which are involved in psoriasis. Th1 cells, types of T cells, increase inflammatory cytokines that cause psoriasis, including interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α) and interleukin-12 (IL-12).

Th17 mechanism

Some biologics target cytokines produced by Th17 cells, which can also cause psoriasis. These cells stimulate secretion of IL-17 cytokines. Biologics can stop these inflammatory cells and reduce the onset of psoriatic arthritis.

What biologics are currently available?

Currently, there are 11 biologics for psoriasis:

  • secukinumab (Cosentyx)
  • etanercept (Enbrel)
  • adalimumab (Humira)
  • infliximab (Remicade)
  • brodalumab (Siliq)
  • ustekinumab (Stelara)
  • ixekizumab (Taltz)
  • guselkumab (Tremfya)
  • certolizumab (Cimzia)
  • tildrakizumab (Ilumya)
  • risankizumab (Skyrizi)

Please refer to the National Psoriasis Foundation for more details and updates on these biologics.

These biologics target different cytokines and inflammatory mediators, so talk to your doctor about which biologic is right for you. Research to develop other biologics for psoriasis is ongoing.

Can biologics be combined with other treatments?

The use of a single drug or a single therapeutic method may not be effective for everyone with psoriasis. If single drugs aren’t working for you, or the effect becomes decreased, it may be time to consider combining biologics with traditional treatments.

There are three main benefits of using a combination approach:

  • It can decrease the possibility of reaching toxic levels with a single drug.
  • The single drug will be prescribed at a lower dose.
  • A combination approach can be more successful than a single dose.

Research from 2014 showed that those taking a biologic, or a biologic along with another form of treatment, are generally more satisfied than those taking topical therapies or acitrecin (Soriatane) alone.

If you feel like your current psoriasis treatment isn’t working, talk to your doctor about biologics. Using biologics, or a combination of biologics with traditional drugs, may be the answer for you.