These new medications can yield life-changing results.
Biologics are one of the newer options for treating psoriasis and psoriatic arthritis—and they’re also one of the most effective.
“Biologic medications can be very helpful to combat psoriasis by working with your immune system to slow down the hyperproliferative state,” says Bobby Buka, MD, dermatologist and section chief at Mount Sinai School of Medicine.
A hyperproliferative state means that the skin is turning over new cells too quickly (faster than it sheds them). As a result, the skin cells build up, and you develop silvery scale-like plaques on the body. Learn more about what psoriasis is here.
The mainstay treatment for psoriasis is topical steroid creams, ointments, and foams; however, for moderate to severe psoriasis, other treatments may be necessary. One of those options is biologic therapy.
Biologics work directly with the immune system to reduce inflammation and psoriasis symptoms. It does this by targeting the exact part of the immune system that causes psoriasis—as opposed to shutting down or suppressing the entire system. By only targeting a specific part of the immune system, your body can still fight infectious bacteria or viruses.
“We’re only deactivating a very small arm of the immune system—the one that’s responsible for psoriasis,” says Dr. Buka. “There are these proteins called cytokines, and when there’s an overproduction of these cytokines, the skin responds by turning over too quickly.”
The biologics bind to cytokines and render them inactive. “Think of a sponge mopping up water. The water’s still there, but the sponge is now absorbed with those cytokines,” says Dr. Buka.
Biologics have revolutionized treatment for psoriasis. For many people who have struggled to find relief, biologic therapy has successfully cleared up their psoriasis symptoms—and just as importantly, helped to prevent progression to psoriatic arthritis.
Dr. Buka is a section chief at Mount Sinai School of Medicine. Dr. Buka is also a diplomate of the American Board of Dermatology and the Society for Pediatric Dermatology.
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Hi, I'm Dr. Bobby Buka.
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I'm the section chief at the Mount Sinai
School of Medicine,
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Department of Dermatology.
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Biologic medications can be very helpful
to combat psoriasis by working with your
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immune system to slow down the
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That means the skin's turning too quickly.
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It's turning over every seven days instead
of every 28 days.
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The result of skin turning over too
quickly is a lot of scale, silvery.
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It's called ostraceous or oyster-like
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Looks like the top of an oyster shell, and
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that's the thick plaques that we'll see on
the scalp, on the knees, on the elbows.
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They're usually more itchy than they are
painful, but they can
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be really life altering, especially in
patients that are meeting new people for
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the first time, and there's a fear that
they're contagious even though
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there's absolutely no contagion to
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Psoriasis is an issue with the immune
system, and our conventional agents,
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the drugs we used to use for
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psoriasis, shut down the entire immune
system in order to combat psoriasis.
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Biologics are different insofar as they
only work on a particular arm of
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the immune system responsible for
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This is important because when we had
conventional agents, older drugs,
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they would shut down the entire immune
system that we need to fight bacteria,
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that we need to fight viruses.
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Now we're only deactivating a very small
arm of the immune system,
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the one that's responsible for psoriasis.
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There are these proteins called cytokines,
and when there's an overproduction of
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these cytokines, the skin responds by
turning over too quickly.
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Biologics work not by slowing the
production of these cytokines, but
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by binding to them, rendering them
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Think of a sponge mopping up water.
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The water's still there, but the sponge is
now absorbed with those cytokines.
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Biologics have been around since the early
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they were used to treat Crohn's disease
and ulcerative colitis.
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They were mainly gastrointestinal drugs.
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Soon we found those patients we were
treating for ulcerative colitis and
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Crohn's disease, their psoriasis was
clearing up really nicely.
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Moderate to severe psoriasis and psoriatic arthritis: biologic drugs. Portland, OR: National Psoriasis Foundation. (Accessed on April 12, 2021 at https://www.psoriasis.org/about-psoriasis/treatments/biologics.)Psoriasis treatment: biologics. Schaumburg, IL: American Academy of Dermatology. (Accessed on April 12, 2021 at https://www.aad.org/public/diseases/scaly-skin/psoriasis/diagnosis-and-treatment-of-psoriasis/biologics.)