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Psoriasis affects over 7.5 million Americans. We think of psoriasis as being a skin disease because of the rash. Actually, psoriasis is an autoimmune disease, the most prevalent one in the United States, which is why new drugs to treat it are aimed at blocking those cells responsible for the skin inflammation. Biologics have been around for over a hundred years but only in the last ten years have been used to treat psoriasis and psoriatic arthritis.
There are five types of psoriasis but plaque psoriasis is the most common. Plaque psoriasis appears as a thick red scaly rash with a whitish coating of old cells that can erupt on many surfaces of the body. People who suffer from psoriasis face incredible embarrassment as they are unable to hide their condition from those around them. Psoriasis is not contagious but can be passed along in families and currently, there is no cure. No one knows what causes psoriasis but there are certain triggers that can aggravate it such as: stress, an injury to the skin like sunburn and certain medications.
Most of the first-line therapies for psoriasis treat the mild symptoms but when the disease is more severe, systemic drugs are used to affect the body’s immune system. Traditional systemic drugs can have serious side effects that may also affect other organs. Biologics are different because they are able to block the activation of specific immune cells called T-cells or the chemical messengers that are involved in creating the inflammation. Biologics are also able to block a chemical call TNF-alpha that cause other cells to release proteins that add to the inflammation.
Currently, there are five biologic drugs that have been approved by the Food and Drug Administration for the treatment of psoriasis:
● Amevive
● Enebrel
● Humira
● Stelara
● Remicade
Some of these biologics are also used to treat other immune diseases such as rheumatoid arthritis, ulcerative colitis and Crohn’s disease. One of the drawbacks to biologic therapy is that these drugs can only be given by injection or by intravenous infusion which can take up to two hours to receive. However, many doctors feel that the benefits of biologics are worth it as there are fewer side effects than with other traditional systemic drugs.
Common side effects while taking biologics are flu-like symptoms, injection reactions or respiratory infections. More serious side effects may be nervous system disorders such as seizures, multiple sclerosis or inflammation of the nerves in the eye.
Biologics can affect the rest of the body’s immune system making the person more susceptible to other infections. These medications cannot be taken if the person has an active infection or immune disease. Patients need to be screened for tuberculosis before starting some of the biologics since they could stir up an inactive infection. On-going blood test monitoring may also be needed.
Biologics should not be prescribed to pregnant women unless there is a clear need as there is no data on their effect on a developing fetus. Overall, long term effects of the use of biologics are unknown as their use is still considered to be new.
Biologics, while not a cure, are thought to be a major step in the treatment of psoriasis as well as offering those suffering some alternative options as well a some new hope.
sources:
www.psoriasis.org
www.steadyhealth.com/articles/Biologics_____New_Treatment_Hope_For_Psoriasis_Sufferers_a745.html
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele can be read at http://www.helium.com/users/487540/show_articles
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