How do biologics work?
Biologics are administered either by subcutaneous injection or intravenous infusion. They are promoted in Europe and worldwide due to their high efficicency and low risk of side effects (high safety profile). The patients who need biologics most are those suffering from moderate or severe plaque psoriasis who did not respond well to traditional topical and systemic therapy. Biologics are in fact essential in patients with the most severe forms of psoriasis.
Patients receiving biologics experience rapid improvement in symptoms, including skin manifestations of psoriasis, without having to apply ointments and receive therapy in inpatient settings. The effects of therapy with biologic agents translate into better quality and comfort of life: patients can be professionally and socially active without feeling embarrassed by their disease.
Biologic therapies target the immune system. Unlike other forms of immunosuppressive agents, biologics only target the sites where psoriasis develops and are suitable for long-term use. Before patients are qualified to receive biologic therapy, they should first undergo a series of medical tests to examine their general health condition and to confirm the absence of tuberculosis. Biologics used in psoriasis mimic the functions of naturally occurring proteins and inhibit the body's immune response. In consequence, they prevent the development of inflammatory conditions of the skin and patients are likely to enjoy increasingly longer symptom-free periods of remission.
Patients confirm that the effects of biologic therapy are almost immediate and that they find relief for longer periods of time. The most common side effects of biologics include injection site reaction, fever, pressure fluctuations, joint and muscle pain. Moreover, when used long-term, biologics may contribute to increased susceptibility to infections and malignant cancer because of their immunosuppressive mechanism of action.
- Pathirana D, et al. J Eur Acad Dermatol Venereol 2009; Oct;23 Suppl 2:1-70.
- Nast A, et al. J Eur Acad Dermatol Venereol 2015; 29:2277-94.
- Hsu S, et al. Arch Dermatol 2012; 148:95-102.
- National Psoriasis Foundation website: https://www.psoriasis.org/biologics/ Accessed March 2021.
- Psoriasis Association SA Webpage: https://psoriasis.org.za/types-treatments/ Accessed March 2021.
- National Psoriasis Foundation Website: https://www.psoriasis.org/treatments-for-psoriatic-disease/ Accessed March 2021.
Recensed by assist. Katarina Trčko, MD, PhD; Department of Dermatology and Venereal Diseases, University Medical Centre Maribor