For example, people with joint pain will benefit from some biologics more than others.
If you have tried a number of psoriasis treatments and haven’t found relief, you might be a candidate for biologics. Luckily, there are many biologics to choose from, so if one doesn’t work for you, you may be able to find relief from another. That leads to an important question: How exactly do you know which biologic for psoriasis is right for you?
The various biologics might be in the same category, but they work in slightly different ways. Some of the main categories include:
- TNF inhibitors, which block tumor necrosis factor
- IL-12 inhibitors, which block interleukin-12
- IL-17 inhibitors, which block interleukin-17
- IL-23 inhibitors, which block interleukin-23
TNF, IL-12, IL-17, and IL-23 are all cytokines, which are proteins in the immune system. Usually, they help your body stay healthy, but they are also responsible for the inflammation in autoimmune diseases like psoriasis. By targeting these specific proteins, you should have less inflammation and reduced psoriasis symptoms.
Choosing a Biologic for Psoriasis
There are a few things your doctor will consider when choosing a biologic for your psoriasis. For example:
- What other conditions are you managing, if any? People with psoriasis have a higher risk of some conditions, including inflammatory bowel disease and heart disease. When picking a biologic for psoriasis, you will want to choose one that won’t negatively affect your other health concerns.
- Do you have joint involvement? About 30 percent of people with psoriasis also have psoriatic arthritis. There are some biologics that can help treat both.
- Are you afraid of needles? The good news is that most people overcome their fear of needles after using a biologic a few times. However, some people with strong fears or discomfort may benefit from a biologic that is taken less frequently.
- What is your weight? There are a few biologics that are dosed based on your weight. These may be beneficial for people who are overweight. That’s because some biologics are made based on “ideal weight” and may thus be less effective in those who are overweight. Learn more here about how weight affects psoriasis here.
Remember: You may need to try more than one biologic for psoriasis to find the one that works for you. It may take a few weeks or months to see results, so it may require some patience. Talk to your doctor about what to expect when starting a new biologic and how to know if your biologic is the right fit for you—or if it’s time to try a new one.
Heather Summe, MD, is a dermatologist in New York City. Dr. Summe is the Chief of the Division of Dermatology at Lenox Hill Hospital. She is also an Assistant Professor of Dermatology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
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