Biologic response modifiers, also known as biologics, are one of the newer developments in psoriasis management. Biologics are designed to target very specific parts of the immune system. They are called biologics because they are protein-based drugs derived from living cells cultured in a laboratory.
Currently in Canada, the approved biologics can be divided into 2 major groups according to how they work: tumour necrosis factor alpha (TNF-alpha) inhibitors and interleukin inhibitors. These type of drugs target various pathways in the immune system to decrease the activity.
- TNF-alpha inhibitors bind and inactivate TNF, which is an important signalling molecule that triggers inflammation.
- Interleukin inhibitors target the signalling molecules that are required to activate various white blood cells responsible for psoriasis.
Due to the unique nature of biologics, they are all administered through subcutaneous (under the skin) or intravenous (into the veins) injection. The common side effects of injection include pain and swelling at the injection site.
Since these drugs are manufactured from components of cells, they can sometimes trigger anallergic reaction. Biologics decrease the activity of the immune system, so they can make the user more susceptible to infections by bacteria, viruses, and fungus. There have been cases where certain infections such as tuberculosis have been reactivated. There have also been reports of increased risk of cancers such as lymphoma with TNF-alpha inhibitor use. Biologic medications are more expensive than existing DMARDs; however, most insurance companies have programs that patients can apply to for reimbursement.
Psoriasis treatment is highly individualized. The development of these new treatments adds even more options for managing your psoriasis. Be sure to work with your doctor closely to find a treatment that satisfies your needs.