Biologics such as adalimumab, alefacept, etanercept, golimumab, infliximab, or ustekinumab are used to treat moderate to severe
chronic plaque psoriasis and
psoriatic arthritis. Some biologics may be used for treating both conditions.
How Well It Works
These biologics significantly reduce
symptoms of psoriasis, providing rapid and sustained improvement. Continued
treatment can lead to extended remission from symptoms.1
One study showed that etanercept was effective for treating psoriasis in children.2
The most common side effect of these
biologics is an allergic reaction to the injection (shot) or infusion (medicine
given in a vein, intravenously, or IV). If you have a reaction to the shot or
infusion, it will happen right away, either during the infusion or within 1 to
2 hours after the infusion or shot. Your doctor may give you medicines to
prevent or stop the reaction.
Symptoms of a shot or infusion site
Fever and chills.
pain and shortness of breath.
redness (flushing) in the
Fatigue and dizziness.
Warnings have been issued about serious side effects of
these biologics. The U.S. Food and Drug Administration (FDA) and the medicine’s
manufacturers have warned about:
An increased risk of a serious infection. TNF antagonists affect
your body's ability to fight all infections. So if you get a fever, cold, or
the flu while you are taking this medicine, let your doctor know right
An increased risk of blood or nervous system disorders. Call
your doctor if you have symptoms of blood disorders (such as bruising or
bleeding) or symptoms of nervous system problems (such as numbness, weakness,
tingling, or vision problems).
A possible increased risk of
lymphoma (a type of blood cancer). It is not clear
whether this increase is because of the drug or because people with this
disease may already have a higher risk.3 There have
been reports of a rare kind of lymphoma, occurring mostly in children and teens
taking some of these biologics, that often results in death.
increased risk of liver injuries. Call your doctor if your skin starts to look
yellow, if you are very tired, or if you have dark brown urine and/or a
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
The safety of long-term treatment
with biologics is not known.
These medicines probably will have to
be taken for long periods of time—possibly even for life.
biologics interfere with the
immune system, it's possible that they may
raise your risk of infection,
anemia, and possibly even cancer. Medicines that
suppress the immune system are not usually given to people with impaired immune
systems. If you take biologic drugs, you may have periodic tests for
Abramowicz M (2008). Drugs for acne, rosacea and
psoriasis. Treatment Guidelines From The Medical Letter,
Paller AS, et al. (2008). Etanercept treatment for children and adolescents with plaque psoriasis. New England Journal of Medicine, 358(3): 241–251.
Menter A, Griffiths CEM (2007). Current and future
management of psoriasis. Lancet, 370(9583):
How this information was developed to help you make better health decisions.